NPIMap

Organization Active NPI

Fall Creek Family Dentist

  • Dental Clinic/Center
  • Ithaca, NY
National Provider Identifier
1356600233
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
044135 Issued in NY
Legal business name
FALL CREEK FAMILY DENTIST
Practice address
501 N Cayuga St
Ithaca, NY 14850-3670
Phone
(607) 272-8118
NPI assigned
May 11, 2012
Last updated
May 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Ms. Kathy Kinney
Title
Office Manager
Phone
(607) 272-8118

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 044297 NY
Dental Clinic/Center 261QD0000X 044135 NY Primary

Addresses

Primary practice location

501 N Cayuga St
Ithaca, NY 14850-3670

Mailing address

501 N Cayuga St
Ithaca, NY 14850-3670
Phone (607) 272-8118

National Provider Directory

National Provider Directory
Tax ID family
Fall Creek Family Dentist2 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.

Locations

501 N Cayuga St
Ithaca, NY 14850
Phone (607) 272-8118

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1356600233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N CAYUGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503670",
            "telephone_number": "607-272-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N CAYUGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503670",
            "telephone_number": "607-272-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK FAMILY DENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "KINNEY",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "607-272-8118",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "044297",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "044135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.