Individual provider Active NPI

Richard Cheltenham, DDS

  • Dentist
  • New Hartford, NY
National Provider Identifier
1386774230
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045610-1 Issued in NY
Practice address
2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613
Phone
(315) 797-3114
Fax
(315) 624-0474
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 045610-1 NY Primary

Addresses

Primary practice location

2050 Tilden Ave
Box 1000
New Hartford, NY 13413-3613

Mailing address

805 Arnold Ave
Utica, NY 13502-5603
Phone (315) 797-3114

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150514001313 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7618297615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045610-1NYMDDentist
045610NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386774230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 ARNOLD AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025603",
            "telephone_number": "315-797-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 TILDEN AVE",
            "address_2": "BOX 1000",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134133613",
            "telephone_number": "315-797-3114",
            "fax_number": "315-624-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELTENHAM",
        "first_name": "RICHARD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045610-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hartford, NY

Sources for this page

Verify at the official NPI Registry.