Richard Etengoff DDS PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0320981 Issued in NY

Legal business name

RICHARD ETENGOFF DDS PC

Practice address

1241 Colvin Ave
Buffalo, NY 14223

Phone

(716) 877-5941

Fax

(716) 877-8409

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Alan Etengoff, DDSNPI 1841486412

Title

President Orthodontist

Phone

(716) 877-5941

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Alan Etengoff, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Buffalo, NY
  • NPI 1841486412
  NPD (past) Authorized official
• Aaron Weisbrot, DPM

  • Podiatrist
  • Buffalo, NY
  • NPI 1851451397
  NPD (past)

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1194911693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 COLVIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14223",
            "telephone_number": "716-877-5941",
            "fax_number": "716-877-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 COLVIN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14223",
            "telephone_number": "716-877-5941",
            "fax_number": "716-877-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD ETENGOFF DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "ETENGOFF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT ORTHODONTIST",
        "authorized_official_telephone_number": "716-877-5941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "0320981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Rice, BA
• Rich Independent Service Coordination
• Adam Rich
• Carrie Rich, LCSW
• Tony Richa, MD
• Richard J Schwartz OD PLLC
• Richard M Costantini, D.D.S., P.C.
• Caleb Richards, PT DPT
• Kalimba M Richards, RN
• Melinda Kay Richards, LMSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.