Individual provider Active NPI

M Naser Sharifi, DDS

  • General Practice Dentistry
  • Floral Park, NY
National Provider Identifier
1902024664
Registry record updated May 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040452 Issued in NY
Practice address
25315 80TH Ave
Floral Park, NY 11004
Phone
(718) 470-9000
Fax
(718) 470-6330
NPI assigned
Apr 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 040452 NY Primary

Addresses

Primary practice location

25315 80TH Ave
Floral Park, NY 11004

Mailing address

25315 80TH Ave
Floral Park, NY 11004-1210
Phone (718) 470-9000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160511002290 NY Order and Referring Only - DentistPractitioner - Dentist 4082903224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1902024664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25315 80TH AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041210",
            "telephone_number": "718-470-9000",
            "fax_number": "718-470-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25315 80TH AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "11004",
            "telephone_number": "718-470-9000",
            "fax_number": "718-470-6330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARIFI",
        "first_name": "M NASER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.