Individual provider Active NPI

Aishwarya Subramanian

  • Dentist
  • Phoenix, AZ
National Provider Identifier
1649806019
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D011043 Issued in AZ
Practice address
22202 N Cave Creek Rd
Phoenix, AZ 85024-7599
Phone
(480) 616-2222
NPI assigned
Mar 18, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X D011043 AZ Primary

Addresses

Primary practice location

22202 N Cave Creek Rd
Phoenix, AZ 85024-7599

Mailing address

1675 E Morten Ave Unit 2139
Phoenix, AZ 85020-4687
Phone (813) 728-7679

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

State licenses

LicenseStateTypeSpecialty
D011043AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Smile Standard, PLLC CurrentSince Jan 2, 2022 Accepting new patients

Locations

22202 N Cave Creek Rd
Phoenix, AZ 85024
Phone (480) 616-2222

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1649806019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E MORTEN AVE UNIT 2139",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204687",
            "telephone_number": "813-728-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22202 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850247599",
            "telephone_number": "480-616-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBRAMANIAN",
        "first_name": "AISHWARYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D011043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.