Individual provider Active NPI

Shaila Vasa, DDS

  • Dentist
  • Roosevelt, NY
National Provider Identifier
1639160559
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
034156 Issued in NY
Practice address
257 Nassau Rd
Roosevelt, NY 11575-1736
Phone
(516) 868-1892
Fax
(516) 868-1892
NPI assigned
Oct 31, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 034156 NY Primary

Addresses

Primary practice location

257 Nassau Rd
Roosevelt, NY 11575-1736

Mailing address

257 Nassau Rd
Roosevelt, NY 11575-1736
Phone (516) 868-1892

Other identifiers 3

IdentifierTypeStateIssuer
0005698OtherDORAL
00350207MedicaidNY
26179OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639160559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 NASSAU RD",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751736",
            "telephone_number": "516-868-1892",
            "fax_number": "516-868-1892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 NASSAU RD",
            "city": "ROOSEVELT",
            "state": "NY",
            "postal_code": "115751736",
            "telephone_number": "516-868-1892",
            "fax_number": "516-868-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASA",
        "first_name": "SHAILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "034156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0005698",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00350207",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "26179",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.