Individual provider Active NPI

Alfred Shirzadnia, DDS

  • Dentist
  • New York, NY
National Provider Identifier
1972786036
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
044531 Issued in NY
Practice address
224 W 35 Street
16 FL.
New York, NY 10001-2529
Phone
(212) 689-0024
Fax
(212) 643-9370
NPI assigned
Dec 12, 2007
Last updated
May 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 044531 NY Primary

Addresses

Primary practice location

224 W 35 Street
16 FL.
New York, NY 10001-2529

Mailing address

224 W 35TH St
16TH FL.
New York, NY 10001-2507
Phone (212) 689-0024

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
I20150416001510 NY Order and Referring Only - DentistPractitioner - Dentist 3577881838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044531NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ian Pasch DDS PC Dentist 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": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1972786036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W 35TH ST",
            "address_2": "16TH FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012507",
            "telephone_number": "212-689-0024",
            "fax_number": "212-643-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W 35 STREET",
            "address_2": "16 FL.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100012529",
            "telephone_number": "212-689-0024",
            "fax_number": "212-643-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRZADNIA",
        "first_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.