Sands-Deforno Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS019463 Issued in PA

Legal business name

SANDS-DEFORNO DENTAL LLC

Practice address

2946 Conestoga Rd
Glenmoore, PA 19343-9516

Phone

(610) 458-7067

Fax

(610) 458-5792

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Sands

Title

Co-Owner/Managing Member

Phone

(610) 458-7067

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1265869887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 CONESTOGA RD",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193439516",
            "telephone_number": "610-458-7067",
            "fax_number": "610-458-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 CONESTOGA RD",
            "city": "GLENMOORE",
            "state": "PA",
            "postal_code": "193439516",
            "telephone_number": "610-458-7067",
            "fax_number": "610-458-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDS-DEFORNO DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "SANDS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CO-OWNER/MANAGING MEMBER",
        "authorized_official_telephone_number": "610-458-7067",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Glenmoore, PA
• Providers in Glenmoore, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.