SG Dental, PC

Primary specialty

DentistTaxonomy code 122300000X

License

032076 Issued in NY

Legal business name

SG DENTAL, PC

Practice address

219 County Route 57
Three Rivers Plaza
Phoenix, NY 13135-3300

Phone

(315) 695-2128

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Sharadchandra Ghanashyam Desai, BDS

Title

President

Phone

(315) 695-2128

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811083124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 COUNTY ROUTE 57",
            "address_2": "THREE RIVERS PLAZA",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353300",
            "telephone_number": "315-695-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 COUNTY ROUTE 57",
            "address_2": "THREE RIVERS PLAZA",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353300",
            "telephone_number": "315-695-2128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESAI",
        "authorized_official_first_name": "SHARADCHANDRA",
        "authorized_official_middle_name": "GHANASHYAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-695-2128",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "032076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Central Schools
• Jennifer Maynard Pratt
• April Quill
• Courtney Lynn Ricard
• Lily Jeannine Roach, M.S. CCC-SLP
• Douglas Shearer, RN, BSN,BLS
• Suzan Mary Elizabeth Sheldon
• Mary E Smith
• Patricia Irene Smith, LPN
• Claudia Sobik, RN

• Dentist in Phoenix, NY
• Providers in Phoenix, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.