Walden Square Dental

Primary specialty

DentistTaxonomy code 122300000X

License

052390 Issued in NY

Legal business name

WALDEN SQUARE DENTAL

Practice address

2523 Walden Ave
Cheektowaga, NY 14225-4737

Phone

(716) 568-2273

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Kevin Clauser

Title

Owner

Phone

(716) 568-2273

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1215468673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 WALDEN AVE",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "14225",
            "telephone_number": "716-568-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2523 WALDEN AVE",
            "city": "CHEEKTOWAGA",
            "state": "NY",
            "postal_code": "142254737",
            "telephone_number": "716-568-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDEN SQUARE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "CLAUSER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-568-2273"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "052390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phyllis J Wagner
• Kelly J Wahl, LMT
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Elena Katherine Walker, PNP
• Julia C Walker, SLP
• Lisa Walker, LPN
• Michele A Walker, SLP

• Dentist in Cheektowaga, NY
• Providers in Cheektowaga, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.