Individual provider Active NPI

Edward A Dwyer, DDS

  • General Practice Dentistry
  • West Seneca, NY
National Provider Identifier
1083717441
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045251 Issued in NY
Practice address
4111 Seneca Street
West Seneca, NY 14224-3045
Phone
(716) 674-5950
Fax
(716) 674-5950
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 045251 NY Primary

Addresses

Primary practice location

4111 Seneca Street
West Seneca, NY 14224-3045

Mailing address

4111 Seneca Street
West Seneca, NY 14224-3045
Phone (716) 674-5950

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
045251NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083717441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 SENECA STREET",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243045",
            "telephone_number": "716-674-5950",
            "fax_number": "716-674-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 SENECA STREET",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243045",
            "telephone_number": "716-674-5950",
            "fax_number": "716-674-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045251",
            "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 8, 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.