Shahin Ghobadi, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

053865 Issued in NY

Practice address

1600 Harrison Ave
Ste 101
Mamaroneck, NY 10543

Phone

(914) 698-4090

Fax

(914) 698-2195

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 22, 2016 through Apr 22, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1902011497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 HARRISON AVE.",
            "address_2": "STE 101",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-698-4090",
            "fax_number": "914-698-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 HARRISON AVE",
            "address_2": "STE 101",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "10543",
            "telephone_number": "914-698-4090",
            "fax_number": "914-698-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOBADI",
        "first_name": "SHAHIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02332400",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "053865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dacia Gentles-Steele
• Kira Antonia Geraci-Ciardullo, M.D.
• Marie Geraghty
• Jayleen Geronimo
• Nicole Gherardi, PT
• Jessica Michelle Giordano
• Mikayla Kesten Girellli, PSYD
• Jason Daniel Gironda
• GKDC Inc.
• Lenore Z. Gladstone, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Mamaroneck, NY
• Providers in Mamaroneck, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.