Individual provider Active NPI

Vered Maslavi, DDS

  • Pediatric Dentistry
  • Bayside, NY
National Provider Identifier
1760644645
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
049740 Issued in NY
Practice address
4505 Francis Lewis Blvd
Bayside, NY 11361-3042
Phone
(718) 279-0900
Fax
(718) 279-0929
NPI assigned
Jul 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 049740 NY Primary

Addresses

Primary practice location

4505 Francis Lewis Blvd
Bayside, NY 11361-3042

Mailing address

4505 Francis Lewis Blvd
Bayside, NY 11361-3042
Phone (718) 279-0900

Other identifiers 2

IdentifierTypeStateIssuer
9176784OtherNYDORAL
02524963MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
049740NYMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1760644645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4505 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613042",
            "telephone_number": "718-279-0900",
            "fax_number": "718-279-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4505 FRANCIS LEWIS BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613042",
            "telephone_number": "718-279-0900",
            "fax_number": "718-279-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASLAVI",
        "first_name": "VERED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "049740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9176784",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02524963",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.