Family Dentistry of Lyons, P.C

Primary specialty

DentistTaxonomy code 122300000X

License

053364 Issued in NY

Legal business name

FAMILY DENTISTRY OF LYONS, P.C

Practice address

52 Broad St
Lyons, NY 14489-1154

Phone

(585) 229-2588

NPI assigned

Mar 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Emmanuel Puddicombe, DDS

Title

Dentist/Owner

Phone

(585) 229-2588

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1417372269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BROAD ST",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144891154",
            "telephone_number": "585-229-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BROAD ST",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144891154",
            "telephone_number": "585-229-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF LYONS, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "PUDDICOMBE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "585-229-2588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "053364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02605329",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles James Drollette Jr., EMT-P
• Valerie Claire Edell, RN, BSN
• Terry Dennise Edwards Sr.
• Cara Elias, PMHNP
• Linda Johanna Eygnor, M.S.
• Family Promise of Wayne County
• Calista Marie Felton, ADVANCED CASAC
• Amy M Fenn, BSW
• Anne Marie Fisher, LPN
• Julie Lyn Foss

• Dentist in Lyons, NY
• Providers in Lyons, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.