Canandaigua Pediatric Dentistry ,PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

035232 Issued in NY

Legal business name

CANANDAIGUA PEDIATRIC DENTISTRY ,PC

Doing business as

Canandaigua Pediactric Dental Group

Practice address

325 West St
Suite 101
Canandaigua, NY 14424-1723

Phone

(585) 394-4058

Fax

(585) 394-4058

NPI assigned

Apr 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark E Wohlfeld, DDSNPI 1558423590

Title

President

Phone

(585) 394-4058

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Canandaigua Pediactric Dental Group Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Elliot Wohlfeld, DDS

  • Dentist
  • Canandaigua, NY
  • NPI 1558423590
  NPD (past) Authorized official
• Jacqueline Palma Wingate, D.M.D., M.P.H.

  • Pediatric Dentistry
  • Canandaigua, NY
  • NPI 1063775989
  NPD (past)

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427170844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "address_2": "SUITE 101",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241723",
            "telephone_number": "585-394-4058",
            "fax_number": "585-394-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WEST ST",
            "address_2": "SUITE 101",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241723",
            "telephone_number": "585-394-4058",
            "fax_number": "585-394-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANANDAIGUA PEDIATRIC DENTISTRY ,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOHLFELD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-394-4058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "035232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS TAX ID#",
            "identifier": "TF2412932",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canandaigua Pediactric Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Canandaigua Emergency Squad, Inc
• Canandaigua Medical Group X-Ray
• Canandaigua Medical Group, P.C.
• Canandaigua Oral Surgery, PC
• Canandaigua Orthopaedic Associates, PC
• Canandaigua Physical Therapy P.C.
• Canandaigua Smiles, LLC
• Canandaigua Trinity OB/GYN, PLLC
• Catherine Cantwell, M.D.
• Joseph Ellis Caravella

• Pediatric Dentistry in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.