Individual provider Active NPI

Robert Tyrus McLanahan, D.D.S.

  • Dentist
  • Buffalo, NY
National Provider Identifier
1356553416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30418 Issued in NY
Practice address
200 Ontario St
Buffalo, NY 14207-1545
Phone
(716) 876-1233
Fax
(716) 876-1234
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30418 NY Primary

Addresses

Primary practice location

200 Ontario St
Buffalo, NY 14207-1545

Mailing address

9 Forestglen Cir
Williamsville, NY 14221-1360
Phone (716) 631-5141

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
30418NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356553416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 FORESTGLEN CIR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211360",
            "telephone_number": "716-631-5141",
            "fax_number": "716-876-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ONTARIO ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071545",
            "telephone_number": "716-876-1233",
            "fax_number": "716-876-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLANAHAN",
        "first_name": "ROBERT",
        "middle_name": "TYRUS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "30418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.