Kourosh Yaghoubian, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046171 Issued in NY

Practice address

1745 Union Blvd
Bay Shore, NY 11706-7937

Phone

(631) 968-5995

Fax

(631) 968-5996

NPI assigned

Nov 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1811978109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067937",
            "telephone_number": "631-968-5995",
            "fax_number": "631-968-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067937",
            "telephone_number": "631-968-5995",
            "fax_number": "631-968-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAGHOUBIAN",
        "first_name": "KOUROSH",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Jemal Woodall, M.D.
• Vertissha Woods, LPN
• Delores Marie Wright, LPN
• Patricia Xu
• Y&S Dental Practice PC.
• Debby Chantalle Yanes
• Ji Can Yang, DO
• Jennifer Yau
• Naila Yazdanie, PHARMACIST
• Tommy Ye, D.D.S.

• General Practice Dentistry in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.