Wading River Complete Dental Care PC

Primary specialty

DentistTaxonomy code 122300000X

License

047469 Issued in NY

Legal business name

WADING RIVER COMPLETE DENTAL CARE PC

Practice address

6278 Route 25a
Wading River, NY 11792

Phone

(631) 929-8709

Fax

(631) 929-8371

NPI assigned

Dec 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Clifford Baynon, DDS

Title

Dentist

Phone

(631) 929-8709

Specialties & licenses 1

Addresses

Other names 1

• Clifford Baynon DDS Other name

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053471391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6278 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "11792",
            "telephone_number": "631-929-8709",
            "fax_number": "631-929-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6278 ROUTE 25A",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "11792",
            "telephone_number": "631-929-8709",
            "fax_number": "631-929-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WADING RIVER COMPLETE DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAYNON",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "631-929-8709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clifford Baynon DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Unbridled Aesthetics
• Sarah Verneuille, RN
• Dawn Verni
• Corinne Brooke Vidulich, M.D.
• Kim Ann Vitacco, NP
• Wading River Fire District
• Wading River Medical Care PC
• Wading River Pediatric Dentistry, PC
• Wading River Physical Therapy, PC
• Jeffrey Todd Wagner, PT, DPT

• Dentist in Wading River, NY
• Providers in Wading River, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.