Individual provider Active NPI

David William Todd, DMD MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Lakewood, NY
National Provider Identifier
1194865907
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
1974071 Issued in NY
Practice address
120 Southwestern Dr
Lakewood, NY 14750
Phone
(716) 484-8091
Fax
(716) 664-2285
NPI assigned
Feb 8, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0452481 NY
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 1974071 NY Primary

Addresses

Primary practice location

120 Southwestern Dr
Lakewood, NY 14750

Mailing address

120 Southwestern Dr
Lakewood, NY 14750
Phone (716) 484-8091

Other identifiers 1

IdentifierTypeStateIssuer
01477343MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160506000540 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355640723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0452481NYMDOral and Maxillofacial Surgery (Dentist)
1974071NYMDOral & Maxillofacial Surgery (D.M.D.)
045248NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1194865907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SOUTHWESTERN DR",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "14750",
            "telephone_number": "716-484-8091",
            "fax_number": "716-664-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTHWESTERN DR",
            "city": "LAKEWOOD",
            "state": "NY",
            "postal_code": "14750",
            "telephone_number": "716-484-8091",
            "fax_number": "716-664-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "DAVID",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "0452481",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "1974071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01477343",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NY

Sources for this page

Verify at the official NPI Registry.