Individual provider Active NPI

Alex Weidenfeld, DMD

  • Dentist
  • Monroe, NY
National Provider Identifier
1265894398
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
059575 Issued in NY
Practice address
138 Stage Rd
Monroe, NY 10950-3513
Phone
(845) 928-5275
NPI assigned
Mar 28, 2016
Last updated
Mar 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02696500 NJ
Dentist 122300000X 059575 NY Primary

Addresses

Primary practice location

138 Stage Rd
Monroe, NY 10950-3513

Mailing address

138 Stage Rd
Monroe, NY 10950-3513
Phone (845) 928-5275

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
I20180220002118 NY Order and Referring Only - DentistPractitioner - Dentist 9638430333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02696500NJMDDentist
059575NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Weidenfeld Endodontics PLLC CurrentSince Aug 4, 2024 Accepting new patients

Locations

207 Route 32
Central Valley, NY 10917
Phone (845) 928-5275

138 Stage Rd
Monroe, NY 10950
Phone (845) 783-4835

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1265894398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 STAGE RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503513",
            "telephone_number": "845-928-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 STAGE RD",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109503513",
            "telephone_number": "845-928-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIDENFELD",
        "first_name": "ALEX",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02696500",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

Verify at the official NPI Registry.