David J Vallecorsa, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

035092 Issued in NY

Practice address

4 Sunset Dr
Latham, NY 12110-2104

Phone

(518) 785-5100

Fax

(518) 785-5171

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• David J. Vallecorsa DDS PLLC

  • General Practice Dentistry
  • Latham, NY
  • NPI 1043045461
  NPD Authorized official

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1427154004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SUNSET DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102104",
            "telephone_number": "518-785-5100",
            "fax_number": "518-785-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SUNSET DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102104",
            "telephone_number": "518-785-5100",
            "fax_number": "518-785-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLECORSA",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "035092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "035095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonid Tumanov, MD
• William A Uhl, D.C.
• United Seating and Mobility LLC
• Maya Valentin, FNP
• Elizabeth Mary Valk, FNP-C
• Gregory Michael Vallecorsa, D.D.S.
• Jonathan David Vallecorsa
• Kim Stuart Van Der Veer, DC, CCSP
• Hoyte T Van Der Zee, M.D.
• Lucy Van Ness, RN

• General Practice Dentistry in Latham, NY
• Providers in Latham, 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 Sep 5, 2024; 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.