Individual provider Active NPI

Mansoor Ashraf, D.D.S.

  • Dentist
  • Bethpage, NY
National Provider Identifier
1811067507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
049394-1 Issued in NY
Practice address
807 S Oyster Bay Rd
Bethpage, NY 11714-1030
Phone
(516) 822-0622
Fax
(516) 342-2480
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 049394-1 NY Primary

Addresses

Primary practice location

807 S Oyster Bay Rd
Bethpage, NY 11714-1030

Mailing address

1329 North Ave
Suite 104
New Rochelle, NY 10804-2689
Phone (516) 822-0622

Other identifiers 1

IdentifierTypeStateIssuer
049394MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
049394-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811067507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 NORTH AVE",
            "address_2": "SUITE 104",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042689",
            "telephone_number": "516-822-0622",
            "fax_number": "516-342-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S OYSTER BAY RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141030",
            "telephone_number": "516-822-0622",
            "fax_number": "516-342-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHRAF",
        "first_name": "MANSOOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049394-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049394",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.