NPIMap

Organization Active NPI

Spa Dental Group Inc.

  • Dental Clinic/Center
  • New York, NY
National Provider Identifier
1346886884
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SPA DENTAL GROUP INC.
Practice address
111 E 57TH St # 204
New York, NY 10022-2009
Phone
(202) 431-6957
NPI assigned
Nov 19, 2019
Organization subpart
Yes
Parent organization
SPA DENTAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Shebani Pahwa, DDSNPI 1962889618
Title
Ceo
Phone
(301) 910-3100

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

111 E 57TH St # 204
New York, NY 10022-2009

Mailing address

111 E 57TH St Ste 204
New York, NY 10022-2009
Phone (917) 858-7155

National Provider Directory

National Provider Directory
Tax ID family
Spa Dental Group Inc2 organizations share this tax ID, including this one
Part of
Spa Dental Group Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1346886884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 57TH ST STE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222009",
            "telephone_number": "917-858-7155",
            "fax_number": "732-631-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 57TH ST # 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222009",
            "telephone_number": "202-431-6957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA DENTAL GROUP INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPA DENTAL GROUP, INC.",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "PAHWA",
        "authorized_official_first_name": "SHEBANI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-910-3100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.