Individual provider Active NPI

Edmond Iryami, DDS

  • General Practice Dentistry
  • Valley Stream, NY
National Provider Identifier
1992861017
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043890 Issued in NY
Practice address
942 Rockaway Ave
Valley Stream, NY 11581-2134
Phone
(516) 561-1884
Fax
(516) 262-3335
NPI assigned
Jan 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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 043890 NY Primary

Addresses

Primary practice location

942 Rockaway Ave
Valley Stream, NY 11581-2134

Mailing address

41C W Merrick Rd Ste 1
Valley Stream, NY 11580-5703
Phone (516) 561-1884

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
043890NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1992861017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41C W MERRICK RD STE 1",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115805703",
            "telephone_number": "516-561-1884",
            "fax_number": "516-792-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 ROCKAWAY AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115812134",
            "telephone_number": "516-561-1884",
            "fax_number": "516-262-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRYAMI",
        "first_name": "EDMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.