Star Dental Care II PC

Primary specialty

DentistTaxonomy code 122300000X

License

047506-1 Issued in NY

Legal business name

STAR DENTAL CARE II PC

Practice address

1528 Main St
Port Jefferson Station, NY 11777-2236

Phone

(631) 473-1338

Fax

(631) 473-1390

NPI assigned

Feb 21, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Shefali Marchawala, DDS

Title

President

Phone

(631) 473-1338

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1720328115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 MAIN ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117772236",
            "telephone_number": "631-473-1338",
            "fax_number": "631-473-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 MAIN ST",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117772236",
            "telephone_number": "631-473-1338",
            "fax_number": "631-473-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR DENTAL CARE II PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "MARCHAWALA",
        "authorized_official_first_name": "SHEFALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-473-1338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047506-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01869305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori J Spitz
• Elizabeth Sprung
• Denise Squillante
• Jeanne Marie Squillante, MS-CCC-SLP; TSSLD
• Karen Stamatopoulos, CCC-SLP
• Kayla Rose Starke
• Christine Stegman, LMSW
• Jeffrey Peter Steigman, PSY.D.
• Ronnie L. Steiner, LCSW-R, CASAC
• Sepideh Steinhandler

• Dentist in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.