Individual provider Active NPI

Pallavi Mehta, DDS

  • Dentist
  • Flushing, NY
National Provider Identifier
1891966313
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
039694 Issued in NY
Practice address
4010 Parsons Blvd
Apt 1C
Flushing, NY 11354-6265
Phone
(718) 358-7180
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 039694 NY Primary

Addresses

Primary practice location

4010 Parsons Blvd
Apt 1C
Flushing, NY 11354-6265

Mailing address

4010 Parsons Blvd
Apt 1C
Flushing, NY 11354-6265
Phone (718) 358-7180

Other identifiers 1

IdentifierTypeStateIssuer
01179744MedicaidNY

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
039694NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1891966313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 PARSONS BLVD",
            "address_2": "APT 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546265",
            "telephone_number": "718-358-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 PARSONS BLVD",
            "address_2": "APT 1C",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113546265",
            "telephone_number": "718-358-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHTA",
        "first_name": "PALLAVI",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "039694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01179744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.