Pooja Anju Agnish, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS028254L Issued in PA

Practice address

113 W Independence St
Shamokin, PA 17872-5315

Phone

(570) 644-3900

Fax

(570) 644-3901

NPI assigned

Sep 21, 2006

Last updated

Nov 12, 2020By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Anju Agnish, DMD PC

  • Dental Clinic/Center
  • Shamokin, PA
  • NPI 1144822420
  NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1891894796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W INDEPENDENCE ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725315",
            "telephone_number": "570-644-3900",
            "fax_number": "570-644-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W INDEPENDENCE ST",
            "city": "SHAMOKIN",
            "state": "PA",
            "postal_code": "178725315",
            "telephone_number": "570-644-3900",
            "fax_number": "570-644-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNISH",
        "first_name": "POOJA",
        "middle_name": "ANJU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS028254L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER TAX ID#",
            "identifier": "680508925",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Shamokin, PA
• Providers in Shamokin, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.