Individual provider Active NPI

Sana Abbas Niitsu, D.D.S

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1417366964
Registry record updated Aug 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
057433 Issued in NY
Practice address
8420 51St Ave
Apartment 2F
Elmhurst, NY 11373-5808
Phone
(317) 523-4142
NPI assigned
Aug 8, 2014
Last updated
Aug 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 057433 NY Primary

Addresses

Primary practice location

8420 51St Ave
Apartment 2F
Elmhurst, NY 11373-5808

Mailing address

8420 51St Ave
Apartment 2F
Elmhurst, NY 11373-5808
Phone (317) 523-4142

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

LicenseStateTypeSpecialty
057433NYMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1417366964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 51ST AVE",
            "address_2": "APARTMENT 2F",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735808",
            "telephone_number": "317-523-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 51ST AVE",
            "address_2": "APARTMENT 2F",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735808",
            "telephone_number": "317-523-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIITSU",
        "first_name": "SANA ABBAS",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-08",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.