Active NPI
James L Tedesco, DDS
- General Practice Dentistry
- West Seneca, NY
National Provider Identifier
1063415503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 032887
- Practice address
- 1643 Orchard Park Rd
West Seneca, NY 14224-4616 - Phone
- (716) 675-3900
- Fax
- (716) 675-2477
- NPI assigned
- May 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 032887 | NY | Primary |
Addresses
Primary practice location
1643 Orchard Park Rd
West Seneca, NY 14224-4616
Mailing address
1643 Orchard Park Rd
West Seneca, NY 14224-4616
Phone (716) 675-3900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 10, 2015 through Nov 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032887 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1063415503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1643 ORCHARD PARK RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142244616",
"telephone_number": "716-675-3900",
"fax_number": "716-675-2477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1643 ORCHARD PARK RD",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "142244616",
"telephone_number": "716-675-3900",
"fax_number": "716-675-2477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCO",
"first_name": "JAMES",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "032887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Seneca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.