Individual provider Active NPI

Conrad C. Howe, D.D.S.

  • General Practice Dentistry
  • Niskayuna, NY
National Provider Identifier
1225488109
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
059213 Issued in NY
Practice address
2317 Balltown Rd Ste 101
Niskayuna, NY 12309-2342
Phone
(518) 370-8086
Fax
(518) 370-8086
NPI assigned
Jun 21, 2016
Last updated
Nov 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 059213 NY Primary

Addresses

Primary practice location

2317 Balltown Rd Ste 101
Niskayuna, NY 12309-2342

Mailing address

2317 Balltown Rd Ste 101
Niskayuna, NY 12309-2342
Phone (518) 370-8086

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
I20171031000057 NY Order and Referring Only - DentistPractitioner - Dentist 1456627827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059213NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1225488109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 BALLTOWN RD STE 101",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123092342",
            "telephone_number": "518-370-8086",
            "fax_number": "518-370-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 BALLTOWN RD STE 101",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123092342",
            "telephone_number": "518-370-8086",
            "fax_number": "518-370-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWE",
        "first_name": "CONRAD",
        "middle_name": "C.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-21",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niskayuna, NY

Sources for this page

Verify at the official NPI Registry.