Eugene Michael Tedaldi Sr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

020483 Issued in NY

Practice address

Main Street 26-28 Village Green
Suite 5
Bedford, NY 10506

Phone

(914) 234-7462

Fax

(914) 763-5544

NPI assigned

Oct 31, 2007

Last updated

Oct 31, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Eugene Michael Tedaldi Sr. Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1053590646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "address_2": "SUITE 5",
            "city": "BEDFORD",
            "state": "NY",
            "postal_code": "10506",
            "telephone_number": "914-234-7462",
            "fax_number": "914-763-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MAIN STREET 26-28 VILLAGE GREEN",
            "address_2": "SUITE 5",
            "city": "BEDFORD",
            "state": "NY",
            "postal_code": "10506",
            "telephone_number": "914-234-7462",
            "fax_number": "914-763-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDALDI",
        "first_name": "EUGENE",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "020483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUGENE",
            "last_name": "TEDALDI",
            "middle_name": "MICHAEL",
            "prefix": "DR.",
            "suffix": "SR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Dentist in Bedford, NY
• Providers in Bedford, NY by specialty
• Dentist in New York

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