Active NPI
Aaron Shea, DDS
- Pediatric Dentistry
- New York, NY
National Provider Identifier
1407471626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 062665
- Practice address
- 220 Madison Ave Ste a
New York, NY 10016-3422 - Phone
- (212) 880-2222
- NPI assigned
- Jun 12, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 062665 | NY | Primary |
Addresses
Primary practice location
220 Madison Ave Ste a
New York, NY 10016-3422
Mailing address
400 Central Park W Apt 3W
New York, NY 10025-5825
Phone (917) 689-1878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 062665 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665100800000",
"number": "1407471626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CENTRAL PARK W APT 3W",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100255825",
"telephone_number": "917-689-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 MADISON AVE STE A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100163422",
"telephone_number": "212-880-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "AARON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-12",
"last_updated": "2022-10-07",
"certification_date": "2022-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "062665",
"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 Oct 7, 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.