Vanguard Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

VANGUARD DENTAL, PLLC

Practice address

200 Old Country Rd
Suite 520
Mineola, NY 11501-4235

Phone

(516) 739-3000

NPI assigned

Aug 17, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Shakiba Jackie Shayani

Title

Director

Phone

(516) 739-3000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345161600000",
    "number": "1598013880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 520",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "516-739-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 520",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "516-739-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2012-08-17",
        "status": "A",
        "authorized_official_last_name": "SHAYANI",
        "authorized_official_first_name": "SHAKIBA",
        "authorized_official_middle_name": "JACKIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "516-739-3000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isaiah Heri Vallecillo, PA-C
• James Valloor, RPA-C
• Eunice Joconde Valmond-Stuppard, P.A.
• Christina Valsamis, M.D.
• Alyssa Vanderhoef, FNP
• Jorge Vargas
• Blessy Chalikottackal Varghese, MS, AGPCNP
• Speros Varinos
• Kevin Varughese
• Joanna Vastardis

• General Practice Dentistry in Mineola, NY
• Providers in Mineola, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; 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.