Organization Active NPI

Michael B. McGrath, DDS, PC

  • General Practice Dentistry
  • Syracuse, NY
National Provider Identifier
1124149745
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
027642 Issued in NY
Legal business name
MICHAEL B. MCGRATH, DDS, PC
Practice address
5108 Velasko Rd
Syracuse, NY 13215-1953
Phone
(315) 478-5719
Fax
(315) 478-5734
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Authorized official

Name
Dr. Michael Burke McGrath, DDS
Title
President
Phone
(315) 478-5719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 027642 NY Primary

Addresses

Primary practice location

5108 Velasko Rd
Syracuse, NY 13215-1953

Mailing address

5108 Velasko Rd
Syracuse, NY 13215-1953
Phone (315) 478-5719

Other identifiers 1

IdentifierTypeStateIssuer
00576903MedicaidNY

National Provider Directory

National Provider Directory

Locations

5108 Velasko Rd
Syracuse, NY 13215
Phone (315) 478-5719

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1124149745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5108 VELASKO RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151953",
            "telephone_number": "315-478-5719",
            "fax_number": "315-478-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 VELASKO RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132151953",
            "telephone_number": "315-478-5719",
            "fax_number": "315-478-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL B. MCGRATH, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "MCGRATH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "BURKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-478-5719",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "027642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00576903",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.