Individual provider Active NPI

Parinda Sanjay Dave, DDS

  • General Practice Dentistry
  • Amityville, NY
National Provider Identifier
1215926159
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043064-1 Issued in NY
Practice address
357 Broadway
Suite 3
Amityville, NY 11701-2748
Phone
(631) 842-6473
Fax
(631) 842-6473
NPI assigned
Oct 13, 2005
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 043064-1 NY Primary

Addresses

Primary practice location

357 Broadway
Suite 3
Amityville, NY 11701-2748

Mailing address

8 Country Court
Farmingdale, NY 11735-4000
Phone (516) 293-6507

Other identifiers 1

IdentifierTypeStateIssuer
01411614MedicaidNY

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
I20151117000775 NY Order and Referring Only - DentistPractitioner - Dentist 9931419272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043064-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215926159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COUNTRY COURT",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354000",
            "telephone_number": "516-293-6507",
            "fax_number": "631-842-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 BROADWAY",
            "address_2": "SUITE 3",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012748",
            "telephone_number": "631-842-6473",
            "fax_number": "631-842-6473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "PARINDA",
        "middle_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043064-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01411614",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.