Individual provider Active NPI

Emanuel Abayev, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Flushing, NY
National Provider Identifier
1861789638
Registry record updated Mar 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
056590-1 Issued in NY
Practice address
7505 Parsons Blvd
Flushing, NY 11366-1037
Phone
(718) 380-1230
NPI assigned
Jun 30, 2011
Last updated
Mar 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 056590-1 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 056590-1 NY Primary

Addresses

Primary practice location

7505 Parsons Blvd
Flushing, NY 11366-1037

Mailing address

13677 72ND Ave
Flushing, NY 11367-2327
Phone (718) 261-1585

Other identifiers 1

IdentifierTypeStateIssuer
03643547MedicaidNY

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
056590-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
My Smiles Orthodontics PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458864000000",
    "number": "1861789638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13677 72ND AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672327",
            "telephone_number": "718-261-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113661037",
            "telephone_number": "718-380-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABAYEV",
        "first_name": "EMANUEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2016-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056590-1",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "056590-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03643547",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.