Southern Tier Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SOUTHERN TIER DENTISTRY, PC

Doing business as

Elmira Family Dentist

Practice address

315 W Church St
Elmira, NY 14901-2601

Phone

(607) 734-8511

Fax

(607) 734-6486

NPI assigned

Apr 23, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Roderick P Schrader

Title

PC Owner

Phone

(715) 926-5050

Specialties & licenses 1

Addresses

Other names 1

• Elmira Family Dentist Doing business as

Locations

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1134516552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 W CHURCH ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012601",
            "telephone_number": "607-734-8511",
            "fax_number": "607-734-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W CHURCH ST",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149012601",
            "telephone_number": "607-734-8511",
            "fax_number": "607-734-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "RODERICK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PC OWNER",
        "authorized_official_telephone_number": "715-926-5050",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmira Family Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Elmira, NY
• Providers in Elmira, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.