Shany C Park, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

048040-1 Issued in NY

Practice address

77 Quaker Ridge Rd
#202
New Rochelle, NY 10804-2808

Phone

(914) 636-5958

NPI assigned

Oct 13, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• New Rochelle Orthodontics PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • New Rochelle, NY
  • NPI 1619134673
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619067675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE RD",
            "address_2": "#202",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-636-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 QUAKER RIDGE RD",
            "address_2": "#202",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108042808",
            "telephone_number": "914-636-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SHANY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "048040-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Paredes Almonte
• Nayana H. Parekh, M.D.
• Christina Parente
• Bruce Douglas Parham, D.D.S
• Rita Parikh, M.D.
• Malika Naiyma Parker
• Gisselle Trisanti Parris, LPN
• Orgeary Deloris Parsley, FNP
• Humayra Parvez, LMSW
• Stephen Pasqua, DDS

• Orthodontics and Dentofacial Orthopedics Dentistry in New Rochelle, NY
• Providers in New Rochelle, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.