Organization Active NPI

Nanuet Family Dentistry

  • General Practice Dentistry
  • Nanuet, NY
National Provider Identifier
1306984794
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048484 Issued in NY
Legal business name
NANUET FAMILY DENTISTRY
Practice address
41 S Middletown Rd
Nanuet, NY 10954-2802
Phone
(845) 624-2265
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Dr. Sharanya Srinivasa, DMD
Title
Owner
Phone
(845) 624-2265

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 048484 NY Primary

Addresses

Primary practice location

41 S Middletown Rd
Nanuet, NY 10954-2802

Mailing address

41 South Middletown Rd
Nanuet, NY 10954-2802
Phone (845) 624-2265

Other identifiers 1

IdentifierTypeStateIssuer
02367971MedicaidNY

National Provider Directory

National Provider Directory

Locations

41 S Middletown Rd
Nanuet, NY 10954
Phone (845) 624-2265

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1306984794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SOUTH MIDDLETOWN RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542802",
            "telephone_number": "845-624-2265",
            "fax_number": "845-624-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 S MIDDLETOWN RD",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542802",
            "telephone_number": "845-624-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANUET FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "SRINIVASA",
        "authorized_official_first_name": "SHARANYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-624-2265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02367971",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nanuet, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.