Yelena Shabala, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02335700 Issued in NY

Practice address

1537 Westchester Ave
Bronx, NY 10472-2908

Phone

(718) 617-0624

NPI assigned

Feb 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boynton Dental,PC

  • General Practice Dentistry
  • Bronx, NY
  • NPI 1952573594
  NPD (past)

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821130329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SPRUCE ST APT 5",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063529",
            "telephone_number": "201-792-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1537 WESTCHESTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104722908",
            "telephone_number": "718-617-0624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABALA",
        "first_name": "YELENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "22DI02335700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02783544",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannette Sfeir
• SH PD Wellness Family Health NP, NP in Psychiatry & RN Practice PLLC
• Kwame Sha
• Mohamed Nafea Shaar, M.D.
• Forogh Shabak
• M Tarek Shabarek, MD
• Nehad Shabarek, MD
• Jahid Shabazz
• Kwameisha Shabazz
• Sajda Shabazz

• General Practice Dentistry in Bronx, NY
• Providers in Bronx, 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 Jul 8, 2007; 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.