NPIMap

Organization Active NPI

Aa Bansal 2

  • Pediatric Dentistry
  • Sammamish, WA
National Provider Identifier
1275989196
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8920 Issued in WA
Legal business name
AA BANSAL 2
Doing business as
PHD COVINGTON LLC
Practice address
615 Windsor Dr SE
Sammamish, WA 98074-3422
Phone
(253) 326-7777
NPI assigned
May 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Dr. Shradha Bansal, DDSNPI 1871745588
Title
Owner
Phone
(425) 891-2461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 8920 WA Primary

Addresses

Primary practice location

615 Windsor Dr SE
Sammamish, WA 98074-3422

Mailing address

615 Windsor Dr SE
Sammamish, WA 98074-3422

Other names 1

  • PHD COVINGTON LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1275989196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WINDSOR DR SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980743422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WINDSOR DR SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980743422",
            "telephone_number": "253-326-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AA BANSAL 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-10",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "BANSAL",
        "authorized_official_first_name": "SHRADHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-891-2461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "8920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHD COVINGTON LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2016; 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.