Active NPI
William Joseph D'Angelo, D.D.S.
- General Practice Dentistry
- Lackawanna, NY
National Provider Identifier
1104116748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 056128
- Practice address
- 1497 Abbott Rd
Lackawanna, NY 14218-2057 - Phone
- (716) 825-5020
- NPI assigned
- Apr 17, 2011
- 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 | 056128 | NY | Primary |
Addresses
Primary practice location
1497 Abbott Rd
Lackawanna, NY 14218-2057
Mailing address
1497 Abbott Rd
Lackawanna, NY 14218-2057
Phone (716) 825-5020
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161103000154 | NY | Order and Referring Only - Dentist | 9032497557 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056128 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southtowns Dental Services PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Hygienist
- Lackawanna, NY
- NPI 1982616033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344384000000",
"number": "1104116748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1497 ABBOTT RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "142182057",
"telephone_number": "716-825-5020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1497 ABBOTT RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "142182057",
"telephone_number": "716-825-5020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "D'ANGELO",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-17",
"last_updated": "2012-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "056128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lackawanna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.