Individual provider Active NPI

Danielle Y Pang, DDS

  • General Practice Dentistry
  • Port Chester, NY
National Provider Identifier
1982836888
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
054554 Issued in NY
Practice address
5 Grace Church St
Port Chester, NY 10573-4911
Phone
(914) 937-8899
NPI assigned
Aug 11, 2009
Last updated
Mar 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 054554 NY Primary

Addresses

Primary practice location

5 Grace Church St
Port Chester, NY 10573-4911

Mailing address

165 Main St
Ossining, NY 10562-4702
Phone (914) 941-1263

Other identifiers 1

IdentifierTypeStateIssuer
03398583MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202002059 OR Order and Referring Only - DentistPractitioner - Dentist 1153621891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054554NYMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: dpang119144@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1982836888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 MAIN ST",
            "city": "OSSINING",
            "state": "NY",
            "postal_code": "105624702",
            "telephone_number": "914-941-1263",
            "fax_number": "914-941-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GRACE CHURCH ST",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105734911",
            "telephone_number": "914-937-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANG",
        "first_name": "DANIELLE",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03398583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Chester, NY

Sources for this page

Verify at the official NPI Registry.