Individual provider Active NPI

Kathleen Lynn McMahon Wahler, DDS

  • General Practice Dentistry
  • Williamsville, NY
National Provider Identifier
1053488080
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043025 Issued in NY
Practice address
1321 Millersport Hwy
Williamsville, NY 14221-2900
Phone
(716) 630-5085
Fax
(716) 630-5086
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 043025 NY Primary

Addresses

Primary practice location

1321 Millersport Hwy
Williamsville, NY 14221-2900

Mailing address

1321 Millersport Hwy
Williamsville, NY 14221-2900
Phone (716) 630-5085

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043025NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1053488080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MILLERSPORT HWY",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212900",
            "telephone_number": "716-630-5085",
            "fax_number": "716-630-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 MILLERSPORT HWY",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212900",
            "telephone_number": "716-630-5085",
            "fax_number": "716-630-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON WAHLER",
        "first_name": "KATHLEEN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.