NPIMap

Organization Active NPI

Sunshine Dental PC

  • Dentist
  • Watertown, NY
National Provider Identifier
1396167532
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SUNSHINE DENTAL PC
Practice address
140 Eastern Blvd
Watertown, NY 13601-3104
Phone
(315) 779-8080
Fax
(855) 217-1118
NPI assigned
Jan 7, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Aeklavya Panjali, DDSNPI 1417086125
Title
Owner
Phone
(315) 779-8080

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

140 Eastern Blvd
Watertown, NY 13601-3104

Mailing address

140 Eastern Blvd
Watertown, NY 13601-3104
Phone (315) 779-8080

National Provider Directory

National Provider Directory
Tax ID family
Sunshine Dental PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1396167532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 EASTERN BLVD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013104",
            "telephone_number": "315-779-8080",
            "fax_number": "855-217-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 EASTERN BLVD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013104",
            "telephone_number": "315-779-8080",
            "fax_number": "855-217-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "PANJALI",
        "authorized_official_first_name": "AEKLAVYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-779-8080",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; 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.