Individual provider Active NPI

Elizabeth Hargrave D'Angelo, D.D.S.

  • Dentist
  • Buffalo, NY
National Provider Identifier
1154619302
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056347-1 Issued in NY
Practice address
215 Squire Hall
Buffalo, NY 14214-8006
Phone
(716) 829-2862
NPI assigned
Jul 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056347-1 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

215 Squire Hall
Buffalo, NY 14214-8006

Mailing address

140 Alexander Way
Orchard Park, NY 14127-4450
Phone (716) 713-8885

Other practice location 1

1660 S Columbian Way
VA Puget Sound HCS, Dental Services S112-Dent
Seattle, WA 98108-1532
Phone (206) 277-1615

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

LicenseStateTypeSpecialty
056347-1NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1154619302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ALEXANDER WAY",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141274450",
            "telephone_number": "716-713-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142148006",
            "telephone_number": "716-829-2862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 S Columbian Way",
            "address_2": "VA Puget Sound HCS, Dental Services S112-Dent",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981081532",
            "country_code": "US",
            "telephone_number": "206-277-1615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'ANGELO",
        "first_name": "ELIZABETH",
        "middle_name": "HARGRAVE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-20",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056347-1",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.