NPIMap

Organization Active NPI

Eastern Niagara Dentistry PLLC

  • General Practice Dentistry
  • Lockport, NY
National Provider Identifier
1225145899
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EASTERN NIAGARA DENTISTRY PLLC
Practice address
57 Davison CT
Ste D
Lockport, NY 14094-5370
Phone
(716) 433-6111
Fax
(716) 433-6029
NPI assigned
Aug 23, 2006
Last updated
Sep 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Authorized official

Name
Dr. David A Keller, DDSNPI 1427285519
Title
Partner/Owner
Phone
(716) 433-6111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

57 Davison CT
Ste D
Lockport, NY 14094-5370

Mailing address

57 Davison CT
Ste D
Lockport, NY 14094-5370
Phone (716) 433-6111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1225145899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 DAVISON CT",
            "address_2": "STE D",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945370",
            "telephone_number": "716-433-6111",
            "fax_number": "716-433-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 DAVISON CT",
            "address_2": "STE D",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945370",
            "telephone_number": "716-433-6111",
            "fax_number": "716-433-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN NIAGARA DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "716-433-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lockport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2009; 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.