NPIMap

Organization Active NPI

Capital Area Hudson Valley Ny Dental PC

  • Dentist
  • Queensbury, NY
National Provider Identifier
1114359387
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
55499 Issued in NY
Legal business name
CAPITAL AREA HUDSON VALLEY NY DENTAL PC
Practice address
123 Quaker Rd
Suite 101
Queensbury, NY 12804-1714
Phone
(518) 746-4125
Fax
(518) 746-4131
NPI assigned
Jul 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Authorized official

Name
Dr. G Stephen Knoll
Title
PC President
Phone
(518) 587-3831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 55499 NY Primary

Addresses

Primary practice location

123 Quaker Rd
Suite 101
Queensbury, NY 12804-1714

Mailing address

6 Executive Park Dr
Suite C
Clifton Park, NY 12065-5601
Phone (518) 348-0240

Other names 1

  • 1st Advantage Dental Queensbury US 9 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Capital Area Hudson Valley Ny Dental PC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

123 Quaker Rd
Ste 101
Queensbury, NY 12804
Phone (518) 240-3750

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1114359387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "address_2": "SUITE C",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "120655601",
            "telephone_number": "518-348-0240",
            "fax_number": "518-348-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 QUAKER RD",
            "address_2": "SUITE 101",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041714",
            "telephone_number": "518-746-4125",
            "fax_number": "518-746-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL AREA HUDSON VALLEY NY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "KNOLL",
        "authorized_official_first_name": "G",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PC PRESIDENT",
        "authorized_official_telephone_number": "518-587-3831",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "55499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Advantage Dental Queensbury US 9",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queensbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.