Organization Active NPI

Bailey Dental,PLLC

  • Dentist
  • Buffalo, NY
National Provider Identifier
1093201253
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BAILEY DENTAL,PLLC
Practice address
2866 Bailey Ave
Buffalo, NY 14215-2802
Phone
(716) 838-6633
Fax
(716) 862-0096
NPI assigned
Jul 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Dr. Camille Nicole Megna-Acorlor, DDS
Title
Owner
Phone
(716) 838-6633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2866 Bailey Ave
Buffalo, NY 14215-2802

Mailing address

2866 Bailey Ave
Buffalo, NY 14215-2802
Phone (716) 838-6633

Other identifiers 1

IdentifierTypeStateIssuer
04665289MedicaidNY

National Provider Directory

National Provider Directory

Locations

2866 Bailey Ave
Buffalo, NY 14215
Phone (716) 838-6633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1093201253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2866 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142152802",
            "telephone_number": "716-838-6633",
            "fax_number": "716-862-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2866 BAILEY AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142152802",
            "telephone_number": "716-838-6633",
            "fax_number": "716-862-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAILEY DENTAL,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "MEGNA-ACORLOR",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-838-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04665289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.