Active NPI
Toothtimedentalstudiopc
- General Practice Dentistry
- New Hyde Park, NY
National Provider Identifier
1144568601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- TOOTHTIMEDENTALSTUDIOPC
- Practice address
- 414 Jericho Tpke
Suit #2
New Hyde Park, NY 11040-4510 - Phone
- (516) 519-8080
- Fax
- (516) 519-8082
- NPI assigned
- Jan 17, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sejal U Shah, DDS
- Title
- President
- Phone
- (515) 519-8080
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary | ||
| Pediatric Dentistry | 1223P0221X | |||
| Periodontics | 1223P0300X | |||
| Dental Hygienist | 124Q00000X | |||
| Dental Assistant | 126800000X |
Addresses
Primary practice location
414 Jericho Tpke
Suit #2
New Hyde Park, NY 11040-4510
Mailing address
PO Box 81
Albertson
Albertson, NY 11507-0081
Phone (516) 519-8080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02145619 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358380800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1358380800000",
"number": "1144568601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 81",
"address_2": "ALBERTSON",
"city": "ALBERTSON",
"state": "NY",
"postal_code": "115070081",
"telephone_number": "516-519-8080",
"fax_number": "516-519-8082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 JERICHO TPKE",
"address_2": "SUIT #2",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110404510",
"telephone_number": "516-519-8080",
"fax_number": "516-519-8082"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOOTHTIMEDENTALSTUDIOPC",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-17",
"last_updated": "2013-01-17",
"status": "A",
"authorized_official_last_name": "SHAH",
"authorized_official_first_name": "SEJAL",
"authorized_official_middle_name": "U",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "515-519-8080",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": false
},
{
"code": "126800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02145619",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.