NPIMap

Organization Active NPI

Capital Area Hudson Valley New York Dental PC

Doing business as 1st Advantage Dental Queensbury US 9

  • General Practice Dentistry
  • Queensbury, NY
National Provider Identifier
1023031085
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC
Doing business as
1st Advantage Dental Queensbury US 9
First Advantage Dental
Practice address
1092 State Route 9
Queensbury, NY 12804-1371
Phone
(518) 798-9561
NPI assigned
Jul 25, 2006
Last updated
May 31, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X NU
General Practice Dentistry 1223G0001X NU Primary
Periodontics 1223P0300X NU
Oral and Maxillofacial Surgery (Dentist) 1223S0112X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU

Addresses

Primary practice location

1092 State Route 9
Queensbury, NY 12804-1371

Mailing address

1092 State Route 9
Queensbury, NY 12804-1371
Phone (518) 798-9561

Other identifiers 1

IdentifierTypeStateIssuer
01145404MedicaidNY

Other names 2

  • 1st Advantage Dental Queensbury US 9 Doing business as
  • First Advantage Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Area Hudson Valley Ny Dental23 organizations share this tax ID, including this one
Part of
Capital Area Hudson Valley Ny Dental

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

1092 State Route 9
Queensbury, NY 12804
Phone (518) 798-9561

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1023031085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 STATE ROUTE 9",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041371",
            "telephone_number": "518-798-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1092 STATE ROUTE 9",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041371",
            "telephone_number": "518-798-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAPITAL AREA HUDSON VALLEY NEW YORK DENTAL PC",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01145404",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Advantage Dental Queensbury US 9",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "First Advantage Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; 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.