Individual provider Active NPI

Sean Challenger

  • Pediatric Dentistry
  • Shirley, NY
National Provider Identifier
1861055246
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
061984 Issued in NY
Practice address
640 Montauk Hwy Ste C
Shirley, NY 11967-2115
Phone
(631) 399-1600
NPI assigned
Apr 21, 2019
Last updated
Sep 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 061984 NY Primary

Addresses

Primary practice location

640 Montauk Hwy Ste C
Shirley, NY 11967-2115

Mailing address

141 E Eckerson Rd
Spring Valley, NY 10977-3133
Phone (845) 659-3161

Other practice location 1

919 Deer Park Ave
North Babylon, NY 11703-3809
Phone (631) 893-7000

Other practice location 2

18-15 Francis Lewis Blvd
Whitestone, NY 11357-3836
Phone (718) 746-1230

Other practice location 3

750 Roanoke Ave
Riverhead, NY 11901-2791
Phone (631) 727-8585

Other practice location 4

7 Mark Tree Rd
Centereach, NY 11720-2221
Phone (631) 585-6600

Other practice location 5

500 Portion Rd Ste 16
Ronkonkoma, NY 11779-4587
Phone (631) 451-7700

Other practice location 6

5036 Jericho Tpke Ste 307
Commack, NY 11725-2812
Phone (631) 203-1145

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
061984NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Smiles for Kids, LLC Pediatric Dentistry PastSince Apr 10, 2022 Accepting new patients
Supersmiles KDS Dental PC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1555804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1861055246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E ECKERSON RD",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109773133",
            "telephone_number": "845-659-3161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 MONTAUK HWY STE C",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672115",
            "telephone_number": "631-399-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "919 Deer Park Ave",
            "address_purpose": "LOCATION",
            "city": "North Babylon",
            "state": "NY",
            "postal_code": "117033809",
            "country_code": "US",
            "telephone_number": "631-893-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18-15 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Whitestone",
            "state": "NY",
            "postal_code": "113573836",
            "country_code": "US",
            "telephone_number": "718-746-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "750 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012791",
            "country_code": "US",
            "telephone_number": "631-727-8585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Mark Tree Rd",
            "address_purpose": "LOCATION",
            "city": "Centereach",
            "state": "NY",
            "postal_code": "117202221",
            "country_code": "US",
            "telephone_number": "631-585-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Portion Rd Ste 16",
            "address_purpose": "LOCATION",
            "city": "Ronkonkoma",
            "state": "NY",
            "postal_code": "117794587",
            "country_code": "US",
            "telephone_number": "631-451-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5036 Jericho Tpke Ste 307",
            "address_purpose": "LOCATION",
            "city": "Commack",
            "state": "NY",
            "postal_code": "117252812",
            "country_code": "US",
            "telephone_number": "631-203-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHALLENGER",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-21",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.