Active NPI
Dena Sapanaro, DDS
- Pediatric Dentistry
- Red Bank, NJ
National Provider Identifier
1508288739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02563100
- Practice address
- 152 Broad St
Red Bank, NJ 07701-2046 - Phone
- (732) 842-5577
- NPI assigned
- Jan 7, 2014
- Last updated
- Oct 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 058998-1 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180919000803 | NY | Order and Referring Only - Dentist | 0345591020 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02563100 | NJ | MD | Pediatric Dentist |
| 058998-1 | NY | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shore Pediatric Dental Group | Single Specialty | Past | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.