Individual provider Active NPI

Michael David Altman, D.D.S.

  • Endodontics
  • Tonawanda, NY
National Provider Identifier
1003938424
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
26804 Issued in NY
Practice address
2545 Sheridan Dr
Tonawanda, NY 14150-9478
Phone
(716) 832-0586
Fax
(716) 832-0301
NPI assigned
Apr 5, 2007
Sex
Male
Sole proprietor
Yes

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
26804NYMDEndodontist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 26804 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

2545 Sheridan Dr
Tonawanda, NY 14150-9478

Mailing address

2545 Sheridan Dr
Tonawanda, NY 14150-9478
Phone (716) 832-0586

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003938424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509478",
            "telephone_number": "716-832-0586",
            "fax_number": "716-832-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509478",
            "telephone_number": "716-832-0586",
            "fax_number": "716-832-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTMAN",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "26804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.