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Active NPI 1598754947 Individual Practitioner Male Practitioner

Dr. Mohammed Mansoorul Imam , DDS

Dentist - General Practice • Elmhurst, NY

Professional Overview & Biography Verified Profile Summary

Dr. Mohammed Imam, DDS is a registered healthcare professional specializing in Dentist - General Practice in Elmhurst, NY. Practice services are available at 5611 94TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5611 94th St
Suite # Ln

Elmhurst, NY 113735080

Telephone 7182714424
Fax 7182714799

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Elmhurst, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
50 Specialists

Practicing in Elmhurst, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 049149

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
02241183 (NY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1013030261

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 12, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location November 12, 2010

Registered at 5611 94TH ST, SUITE # LN, ELMHURST, NY 113735080 (Tel: 7182714424)

📍
Updated Business Mailing Address November 12, 2010

Registered at 5611 94TH ST, SUITE # LN, ELMHURST, NY 113735080 (Tel: 7182714424)

👤
Provider Name / Credentials Updated November 12, 2010

Recorded as MOHAMMED IMAM, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 12, 2010

Dentist (License #049149 in NY)

🟢
Initial NPI Registration & Enumeration October 18, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598754947
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 18, 2005
Last Update: November 12, 2010
Sole Proprietor: Yes

Mailing Address

5611 94th St, Suite # Ln

Elmhurst, NY 113735080

Phone: 7182714424

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.