Stephen J Illig, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

030190 Issued in NY

Practice address

987 R C Hoag Dr
Salamanca, NY 14779-1365

Phone

(716) 945-5894

Fax

(716) 242-6345

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Seneca Nation of Indians

  • Federally Qualified Health Center (FQHC)
  • Salamanca, NY
  • NPI 1023033511
  NPD (past)
• Seneca Nation of Indians

  dba Lionel R John Health Center

  • Federally Qualified Health Center (FQHC)
  • Salamanca, NY
  • NPI 1609882976
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1336233477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 R C HOAG DR",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147791365",
            "telephone_number": "716-945-5894",
            "fax_number": "716-242-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 R C HOAG DR",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147791365",
            "telephone_number": "716-945-5894",
            "fax_number": "716-242-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIG",
        "first_name": "STEPHEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "030190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "4001458",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WNYBCBS",
            "identifier": "007016271",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00807727",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "143435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Hinman
• Judith Anne Hoag, LPN
• Lauren Kathlene Hunt, DPT
• Anne Huselstein, RPH
• Peter K Illig, RPH PHARMACIST
• Erica Ashley Jeter
• John, Ross L., Sr. Native Pharmaceutical Direct (Native Pharmaceutical Direct)
• Michael Kalsman, MD
• Emily M Karn, PA
• Amy L. Kellogg, M.S.

• General Practice Dentistry in Salamanca, NY
• Providers in Salamanca, 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 Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.