Shradha Bansal, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE00008920 Issued in WA

Practice address

85 NW Alder PL Ste B
Issaquah, WA 98027-3201

Phone

(425) 657-0609

Fax

(866) 528-2025

NPI assigned

Oct 14, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Aa Bansal 2

  • Pediatric Dentistry
  • Sammamish, WA
  • NPI 1275989196
  NPD (past) Authorized official
• Aa Bansal PLLC

  • Pediatric Dentistry
  • Tacoma, WA
  • NPI 1356596811
  NPD (past) Authorized official

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1871745588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WINDSOR DR SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980743422",
            "telephone_number": "425-830-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 NW ALDER PL STE B",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980273201",
            "telephone_number": "425-657-0609",
            "fax_number": "866-528-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Windsor Dr SE",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980743422",
            "country_code": "US",
            "telephone_number": "425-830-4773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANSAL",
        "first_name": "SHRADHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-14",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00008920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saige Danielle Ballard
• Banic Chiropractic Company
• Ante Banic, D.C.
• Leslie Marie Banic, D.C.
• Larry Banning, LMP
• Pilar Baquero-Young, MD
• Simon Barei
• Stacey B Bargmeyer-Hutchison, AUD
• Anne Marie Barlow, LMP
• Sigird Karin Barnickel, MD

• Pediatric Dentistry in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.