Active NPI
John William Lefevre, DDS
- Dentist
- Clyde, NY
National Provider Identifier
1104984723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 023269
- Practice address
- 105 Glasgow St
Clyde, NY 14433-0133 - Phone
- (315) 923-3231
- NPI assigned
- Dec 5, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 023269 | NY | Primary |
Addresses
Primary practice location
105 Glasgow St
Clyde, NY 14433-0133
Mailing address
PO Box 133
105 Glasgow St
Clyde, NY 14433-0133
Phone (315) 923-3231
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023269 | Other | NY | LICENSE # |
| 00447521 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 023269 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104984723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 133",
"address_2": "105 GLASGOW ST",
"city": "CLYDE",
"state": "NY",
"postal_code": "144330133",
"telephone_number": "315-923-3231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 GLASGOW ST",
"city": "CLYDE",
"state": "NY",
"postal_code": "144330133",
"telephone_number": "315-923-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEFEVRE",
"first_name": "JOHN",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "023269",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "023269",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00447521",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clyde, 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.