John D. Callahan Jr., D.D.S., M.S.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Fayetteville, NY
NPI 1043347438 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1043347438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 0365091 (NY)
- Practice address
- 300 S Manlius St
Fayetteville, NY 13066-2041 - Phone
- (315) 663-0295
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0365091 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Callahan, Flanagan & Smith Orthodontics | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 0365091 | NY | Yes |
Addresses
Primary practice location
300 S Manlius St
Fayetteville, NY 13066-2041
Mailing address
300 S Manlius St
Fayetteville, NY 13066-2041
Phone (315) 663-0295
Other providers in Fayetteville, NY
- Cornelia Maria Buur
- Joseph L Byrne
- Michael F Cadin
- Robert Cady
- Callahan, Flanagan & Smith Orthodontics
- Julie C Cannizzo
- Phoebe Geralyn Cannon
- Phillip Capozzi
- Melissa Carman
- Gavin Geoffrey Carvey
All providers in Fayetteville, NY · Orthodontics and Dentofacial Orthopedics Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.