Active NPI
Sujatha H de Silva DDS PC
- Dental Clinic/Center
- Port Jervis, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- SUJATHA H DE SILVA DDS PC
- Practice address
- 141 Pike Street
Port Jervis, NY 12771 - Phone
- (845) 856-4002
- Fax
- (845) 856-4002
- NPI assigned
- Jan 27, 2006
- Last updated
- Aug 11, 2009
- 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
- Sujatha H De Silva, DDS
- Title
- Principal
- Phone
- (845) 856-4002
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
141 Pike Street
Port Jervis, NY 12771
Mailing address
141 Pike Street
Port Jervis, NY 12771
Phone (845) 856-4002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00946341 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Sujatha H de Silva DDS PC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dental Clinic/Center
- Staten Island, NY
- NPI 1871564054
-
- General Practice Dentistry
- Port Jervis, NY
- NPI 1265696058
Locations
141 Pike St
Port Jervis, NY 12771
Phone (845) 856-4002
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- General Practice Dentistry
- Port Jervis, NY
- NPI 1639251846
-
- Dentist
- Port Jervis, NY
- NPI 1861721367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1249948800000",
"number": "1447221627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 PIKE STREET",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "12771",
"telephone_number": "845-856-4002",
"fax_number": "845-856-4002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 PIKE STREET",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "12771",
"telephone_number": "845-856-4002",
"fax_number": "845-856-4002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUJATHA H DE SILVA DDS PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-27",
"last_updated": "2009-08-11",
"status": "A",
"authorized_official_last_name": "DE SILVA",
"authorized_official_first_name": "SUJATHA",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRINCIPAL",
"authorized_official_telephone_number": "845-856-4002",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00946341",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.