Active NPI
Pediatric Dentistry
- Pediatric Dentistry
- Glens Falls, NY
National Provider Identifier
1407993611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- Legal business name
- PEDIATRIC DENTISTRY
- Practice address
- 88 Broad Street
Glens Falls, NY 12801 - Phone
- (518) 798-9966
- Fax
- (518) 798-0616
- NPI assigned
- Jan 30, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Farzad Sani, DDS
- Title
- Partner
- Phone
- (518) 798-9966
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | NU | Primary |
Addresses
Primary practice location
88 Broad Street
Glens Falls, NY 12801
Mailing address
88 Broad Street
Glens Falls, NY 12801
Phone (518) 798-9966
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q428 | Other | NY | CDPHP |
| 816446 | Other | NY | UNITED CONCORDIA |
| 105880 | Other | NY | DORAL DENTAL |
| X00129970 | Other | NY | EXCELLUS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pediatric Dentistry
- Glens Falls, NY
- NPI 1073503504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1407993611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 BROAD STREET",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "12801",
"telephone_number": "518-798-9966",
"fax_number": "518-798-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 BROAD STREET",
"city": "GLENS FALLS",
"state": "NY",
"postal_code": "12801",
"telephone_number": "518-798-9966",
"fax_number": "518-798-0616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PEDIATRIC DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-30",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SANI",
"authorized_official_first_name": "FARZAD",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "518-798-9966",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "Q428",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "816446",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL DENTAL",
"identifier": "105880",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EXCELLUS",
"identifier": "X00129970",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glens Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.