Cory Wanatick, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

043406-1 Issued in NY

Practice address

583 Route 32
Highland Mills, NY 10930

Phone

(845) 928-3348

NPI assigned

Feb 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Cory a. Wanatick,D.M.D.,P.a.

  • Periodontics
  • Fort Lee, NJ
  • NPI 1508924754
  NPD (past) Authorized official
• Dan Landmann MD LLC

  • Ophthalmology Physician
  • River Edge, NJ
  • NPI 1598175002
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194866517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 FRANKLIN TPKE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301341",
            "telephone_number": "201-529-5999",
            "fax_number": "201-529-0180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 ROUTE 32",
            "city": "HIGHLAND MILLS",
            "state": "NY",
            "postal_code": "10930",
            "telephone_number": "845-928-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANATICK",
        "first_name": "CORY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043406-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Velazquez-Sanchez, LMHC, NCC
• Nahomie Victor-Charlot
• Donato B Villanueva Jr., P.T
• Vista Analysis Inc
• Farisha Walters
• Sharon Watson, LCSW
• Rebecca Ivonne White, NP
• Sonia White
• Woodbury Pharmacy
• Kimberly A Wragge, COTA

• Dentist in Highland Mills, NY
• Providers in Highland Mills, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.