Spa Dental, PC

Primary specialty

DentistTaxonomy code 122300000X

License

046659 Issued in NY

Legal business name

SPA DENTAL, PC

Practice address

68 Milton Avenue
Ballston Spa, NY 12020

Phone

(518) 885-1791

Fax

(518) 885-1147

NPI assigned

Sep 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. James T Hansen, D,M.D.NPI 1013122357

Title

Owner/President

Phone

(518) 885-1791

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James T Hansen, D.M.D.

  • General Practice Dentistry
  • Ballston Spa, NY
  • NPI 1013122357
  NPD (past) Authorized official
• Ronald L Faigin, D.M.D.

  • General Practice Dentistry
  • Ballston Spa, NY
  • NPI 1679520563
  NPD (past)

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1700135886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 MILTON AVENUE",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-885-1791",
            "fax_number": "518-885-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 MILTON AVENUE",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "12020",
            "telephone_number": "518-885-1791",
            "fax_number": "518-885-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "518-885-1791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D,M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "046659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03275514",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Michele Smullen, MS PT
• Johanna Sno, OTR/L
• Jacqueline Snow, RN
• Laura F Snyder, PT
• Southern Adirondack Midwifery
• St. Peter's Health Partners Medical Associates, P.C.
• Susan E Stasch
• Amber Jasmine Stephens
• Barbara Stevens, 0029351
• Darlene C Stiffler, LCSW

• Dentist in Ballston Spa, NY
• Providers in Ballston Spa, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.