Banana Smiles Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

BANANA SMILES PEDIATRIC DENTISTRY PLLC

Practice address

5611 94TH St Ste LN
Elmhurst, NY 11373-5004

Phone

(718) 760-8700

NPI assigned

Apr 24, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Fawaz Shihadeh, DDSNPI 1053815282

Title

Pediatric Dentist/ Owner

Phone

(561) 716-8623

Specialties & licenses 1

Addresses

Locations

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.

• Fawaz Omar Shihadeh, DDS

  • Pediatric Dentistry
  • Bronx, NY
  • NPI 1053815282
  NPD Authorized official

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1447947924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HERKIMER ST APT 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112166582",
            "telephone_number": "561-716-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 94TH ST STE LN",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735004",
            "telephone_number": "718-760-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANANA SMILES PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "SHIHADEH",
        "authorized_official_first_name": "FAWAZ",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST/ OWNER",
        "authorized_official_telephone_number": "561-716-8623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Ballesteros Gomez, O.D.
• Adriane Clark Salazar Ballesteros, PTA
• Dimitrios Anargyros Bampatsias, MD
• Dorit Bamshad, PA-C
• Yoomi Ban
• Claude M Banatte
• Mark Banchik, M.D.
• Sheahara Mae Amistoso Bancure
• Nayab Bangash, MD
• Jazel Atienza Baniqued, P.T.

• Pediatric Dentistry in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.