Individual provider Active NPI

Wendell Antonio Carmona, DDS

  • General Practice Dentistry
  • Niagara Falls, NY
National Provider Identifier
1295292837
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
061172 Issued in NY
Practice address
7426 Niagara Falls Blvd
Niagara Falls, NY 14304-1720
Phone
(716) 371-4284
NPI assigned
Mar 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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 061172 NY Primary

Addresses

Primary practice location

7426 Niagara Falls Blvd
Niagara Falls, NY 14304-1720

Mailing address

7426 Niagara Falls Blvd
Niagara Falls, NY 14304-1720
Phone (716) 371-4284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
061172NYMDGeneral Practice Dentistry

Practice roles (1 of 2)

OrganizationSpecialtyStatusNew patients
William Blanford DDS PLLC General Practice CurrentSince Dec 13, 2020 Accepting new patients

Locations

7426 Niagara Falls Blvd
Niagara Falls, NY 14304
Phone (716) 371-4284

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1295292837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7426 NIAGARA FALLS BLVD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041720",
            "telephone_number": "716-371-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7426 NIAGARA FALLS BLVD",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "143041720",
            "telephone_number": "716-371-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "WENDELL",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-01",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niagara Falls, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.