NPIMap

Organization Active NPI

Ausable Dental Center

  • Dentist
  • Au Sable Forks, NY
National Provider Identifier
1336671049
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054556-1 Issued in NY
Legal business name
AUSABLE DENTAL CENTER
Practice address
30 N Main St
Au Sable Forks, NY 12912
Phone
(518) 647-5150
Fax
(518) 647-4532
NPI assigned
Mar 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Authorized official

Name
Dr. George K Sarandev, D.D.S.
Title
Dentist/Owner
Phone
(518) 647-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 054556-1 NY Primary

Addresses

Primary practice location

30 N Main St
Au Sable Forks, NY 12912

Mailing address

PO Box 775
Au Sable Forks, NY 12912-0775
Phone (518) 647-5150

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": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1336671049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "129120775",
            "telephone_number": "518-647-5150",
            "fax_number": "518-647-4532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MAIN ST",
            "city": "AU SABLE FORKS",
            "state": "NY",
            "postal_code": "12912",
            "telephone_number": "518-647-5150",
            "fax_number": "518-647-4532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSABLE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "SARANDEV",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "518-647-5150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "054556-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Au Sable Forks, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.