Individual provider Active NPI

Dena Sapanaro, DDS

  • Pediatric Dentistry
  • Red Bank, NJ
National Provider Identifier
1508288739
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02563100 Issued in NJ
Practice address
152 Broad St
Red Bank, NJ 07701-2046
Phone
(732) 842-5577
NPI assigned
Jan 7, 2014
Last updated
Oct 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 058998-1 NY
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 22DI02563100 NJ Primary

Addresses

Primary practice location

152 Broad St
Red Bank, NJ 07701-2046

Mailing address

PO Box 396
White Lake, NY 12786-0396
Phone (551) 427-6536

Other practice location 1

377 E 33rd St
New York, NY 10016-9474
Phone (551) 427-6536

Other practice location 2

345 E 24th St
New York, NY 10010-4020
Phone (212) 992-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180919000803 NY Order and Referring Only - DentistPractitioner - Dentist 0345591020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02563100NJMDPediatric Dentist
058998-1NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Pediatric Dental Group Single Specialty PastSince Oct 11, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1508288739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "WHITE LAKE",
            "state": "NY",
            "postal_code": "127860396",
            "telephone_number": "551-427-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012046",
            "telephone_number": "732-842-5577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "377 E 33rd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169474",
            "country_code": "US",
            "telephone_number": "551-427-6536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 E 24th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100104020",
            "country_code": "US",
            "telephone_number": "212-992-7025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAPANARO",
        "first_name": "DENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "058998-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02563100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.