Individual provider Active NPI

Michelle Wesley, D.M.D

  • General Practice Dentistry
  • Somers, NY
National Provider Identifier
1154853679
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060969 Issued in NY
Practice address
4 Heritage Hills 202 Ctr
Somers, NY 10589-1600
Phone
(914) 277-4222
NPI assigned
Apr 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN03454 RI
General Practice Dentistry 1223G0001X 060969 NY Primary

Addresses

Primary practice location

4 Heritage Hills 202 Ctr
Somers, NY 10589-1600

Mailing address

4 Heritage Hills 202 Ctr
Somers, NY 10589-1600
Phone (914) 277-4222

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
DEN03454RIMDDentist
060969NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
GRF Dental PLLC CurrentSince Dec 15, 2024 Accepting new patients
Dutchman Dental LLC General Practice Past Accepting new patients
Dutchmen Dental LLC General Practice Past Accepting new patients

Locations

4 Heritage Hills 202 Ctr
Somers, NY 10589
Phone (631) 848-8730

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1154853679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HERITAGE HILLS 202 CTR",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105891600",
            "telephone_number": "914-277-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HERITAGE HILLS 202 CTR",
            "city": "SOMERS",
            "state": "NY",
            "postal_code": "105891600",
            "telephone_number": "914-277-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESLEY",
        "first_name": "MICHELLE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-06-01",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "RI",
            "license": "DEN03454",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somers, NY

Sources for this page

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