Waise Ebrahimi DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WAISE EBRAHIMI DDS PC

Doing business as

Smile Lab

Practice address

841 Broadway
New York, NY 10003-4704

Phone

(332) 237-6453

NPI assigned

Jan 5, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Waise Ebrahimi, DDSNPI 1649622945

Title

President

Phone

(925) 548-7869

Specialties & licenses 1

Addresses

Other names 1

• Smile Lab Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Waise Omid Ebrahimi, D.D.S.

  • Dentist
  • New York, NY
  • NPI 1649622945
  NPD Authorized official

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1871181826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034704",
            "telephone_number": "925-548-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034704",
            "telephone_number": "332-237-6453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Broadway Ste D",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100122614",
            "country_code": "US",
            "telephone_number": "925-548-7869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WAISE EBRAHIMI DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "EBRAHIMI",
        "authorized_official_first_name": "WAISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-548-7869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Wainfeld
• Jeffrey Joseph Wainstein, PHD, MA
• Caren Waintraub
• Lauren Wainwright, MSOT
• Zoe Wais
• Agostina Waisfeld
• Liandra Waisome, NP
• David B Wait, MD
• Lindsey Anne Wait
• Carolyn Marie Waite, PHYSICIAN ASSISTANT

• General Practice Dentistry in New York, NY
• Providers in New York, 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 5, 2023; 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.