SPA DENTAL, PC (NPI# 1700135886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700135886 |
| Entity Type | Organization |
| Organization Name | SPA DENTAL, PC |
| Practice Address |
68 Milton Avenue Ballston Spa NY 12020 |
| Practice Telephone | 5188851791 |
| Practice Fax Number | 5188851147 |
| Mailing Telephone | 5188851791 |
| Mailing Fax Number | 5188851147 |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |
| Authorized Official Name | DR. JAMES T HANSEN (OWNER/PRESIDENT) |
| Authorized Official Telephone | 5188851791 |
| Authorized Official Credential | D,M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 046659 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03275514 | 05 |
| Street Address |
68 MILTON AVENUE |
| City | BALLSTON SPA |
| State | NY |
| Zip Code | 12020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811529415 | Peter Joseph Valastro Jr. | Registered Nurse | 2452 Us Rt 9 Suite 206, Malta, NY 12020 | 2020-02-11 |
| 1083257224 | Martins Foods of South Burlington LLC | Durable Medical Equipment & Medical Supplies | 3 Via Rossi Way, Ballston Spa, NY 12020 | 2019-10-21 |
| 1528542255 | Mary Szacik | Social Worker | 2452 Us Rt. 9, Suite 206, Malta, NY 12020 | 2018-09-19 |
| 1669966867 | Adam Smatko | Social Worker | 2452 Us Route 9, Suite 206, Malta, NY 12020 | 2018-06-20 |
| 1538665104 | Tressa Frese | Counselor | 35 Bath Street, Ballston Spa, NY 12020 | 2018-04-03 |
| 1902312556 | Maltavista Optometry, Pllc | Optometrist | 2715 Rt 9, Suite 204, Malta, NY 12020 | 2017-12-19 |
| 1497207294 | Julie Lapham | Counselor | 100 Saratoga Village Blvd. Suite 26, Malta, NY 12020 | 2016-10-27 |
| 1932656527 | Matthew Kattell | Physical Therapist | 4102 Ellsworth Boulevard, Malta, NY 12020 | 2016-09-01 |
| 1295134740 | Nnenna Lindsay | Psychologist | 15 Trieble Avenue, Suite 5 Pmb 1013, Ballston Spa, NY 12020 | 2014-08-21 |
| 1023425956 | Jessica Duell | Registered Nurse | 603 Sweetman Road, Ballston Spa, NY 12020 | 2014-07-11 |
| Find all providers in zip 12020 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972712396 | Craig Frederick Walton | Dentist | 424 Geyser Road, Ballston Spa, NY 12020 | 2007-05-22 |
| 1205042736 | Jan P Fugal | Dentist | 348 Milton Ave, Ballston Spa, NY 12020-1415 | 2007-05-14 |
| 1376874461 | W & R Geyser Rd, LLC | Dentist | 424 Geyser Rd, Ballston Spa, NY 12020-3021 | 2010-01-29 |
| 1023184975 | James Reynolds | Dentist | 520 Route 67, Ballston Spa, NY 12020 | 2006-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831790088 | Pamela A Michelotti | Dentist | 1003 Richmond Ave Ste A, Staten Island, NY 10314-1584 | 2020-11-04 |
| 1336749530 | Suffolk Dental Care, PC | Dentist | 3650 Route 112 Ste 105, Coram, NY 11727-4131 | 2020-10-27 |
| 1457959207 | The Dental Equation, Pllc | Dentist | 626 E Boston Post Rd, Mamaroneck, NY 10543 | 2020-10-14 |
| 1255938551 | Steven Kauftheil Dds Pllc | Dentist | 630 5th Ave Ste 1815, New York, NY 10111-1872 | 2020-10-08 |
| 1316553613 | Hihland Falls Dental Associate | Dentist | 70 Villa Pkwy, Highland Falls, NY 10928-1615 | 2020-09-22 |
| 1679188130 | Glen Cove Dental P.C. | Dentist | 44 Elm St Ste 1, Huntington, NY 11743-3403 | 2020-09-11 |
| 1255945945 | Derek Lin | Dentist | 10750 Queens Blvd Ste 2, Forest Hills, NY 11375-4266 | 2020-09-01 |
| 1104436690 | Maryam Ghorbani | Dentist | 40 Waterside Plz Apt 12b, New York, NY 10010-2636 | 2020-08-09 |
| 1700495272 | Casey Depauw | Dentist | 1066 Abbott Rd # 1, Buffalo, NY 14220-2756 | 2020-07-30 |
| 1194334607 | Asnis Dental Pllc | Dentist | 112 Alexander Ave Unit A, Lake Grove, NY 11755-0429 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | BALLSTON SPA |
| Zip Code | 12020 |
Please comment or provide details below to improve the information on SPA DENTAL, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.