Cazenovia Creekside Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CAZENOVIA CREEKSIDE DENTAL, PLLC

Practice address

4 Chenango St
Cazenovia, NY 13035-1400

Phone

(315) 655-5885

NPI assigned

Mar 24, 2021

Organization subpart

Yes

Parent organization

LALOR DENTISTRY, PCAs reported in NPPES

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

Authorized official

Name

Dr. Robert A. Lalor, DDS

Title

President

Phone

(607) 754-2217

Specialties & licenses 1

Addresses

Tax ID family

Cazenovia Creekside Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunny Dental Fayetteville

  • General Practice Dentistry
  • Fayetteville, NY
  • NPI 1700732732
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sunny Jung, DMD

  • General Practice Dentistry
  • Cazenovia, NY
  • NPI 1073330510
  NPD
• Ke John Kweun, DDS

  • General Practice Dentistry
  • Cazenovia, NY
  • NPI 1912312505
  NPD

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1295312528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 VESTAL PKWY W",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501056",
            "telephone_number": "607-754-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CHENANGO ST",
            "city": "CAZENOVIA",
            "state": "NY",
            "postal_code": "130351400",
            "telephone_number": "315-655-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAZENOVIA CREEKSIDE DENTAL, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LALOR DENTISTRY, PC",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-754-2217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gianna Nicole Bushey
• Valerie Butler
• Cazenovia Area Volunteer Ambulance Corps Inc
• Cazenovia Central School District
• Cazenovia College
• Pauline Cecere, LCSW
• Cherry Valley Physical Therapy, PLLC
• Cassandra Tze Ka Cheung, MD
• Sheila Clonan, PH.D.
• Jenna Cherie Cole

• General Practice Dentistry in Cazenovia, NY
• Providers in Cazenovia, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.