Schenectady Oral and Maxillofacial Surgery Associates

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

034224 Issued in NY

Legal business name

SCHENECTADY ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES

Practice address

2141 Eastern Pkwy
Schenectady, NY 12309-6347

Phone

(518) 372-2859

Fax

(518) 370-5983

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa M Duval

Title

Office Manager

Phone

(518) 372-2859

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Lionel Angelo Bulford, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Saratoga Springs, NY
  • NPI 1033149018
  NPD (past)

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1124115373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 EASTERN PKWY",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096347",
            "telephone_number": "518-372-2859",
            "fax_number": "518-370-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 EASTERN PKWY",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096347",
            "telephone_number": "518-372-2859",
            "fax_number": "518-370-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHENECTADY ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "518-372-2859",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "034224",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044618",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01471952",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00550087",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Schenectady, NY
• Providers in Schenectady, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.