Individual provider Active NPI

Ryan Edward Wolpert, D.D.S.

  • General Practice Dentistry
  • Saratoga Springs, NY
National Provider Identifier
1093802399
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052063 Issued in NY
Practice address
121 Lake Ave
Saratoga Springs, NY 12866-2420
Phone
(518) 587-8225
NPI assigned
Oct 6, 2006
Sex
Male
Sole proprietor
Yes

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 052063 NY Primary

Addresses

Primary practice location

121 Lake Ave
Saratoga Springs, NY 12866-2420

Mailing address

121 Lake Ave
Saratoga Springs, NY 12866-2420
Phone (518) 487-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201000012 NY Order and Referring Only - DentistPractitioner - Dentist 8123300902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093802399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 LAKE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662420",
            "telephone_number": "518-487-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 LAKE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128662420",
            "telephone_number": "518-587-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLPERT",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.