Individual provider Active NPI

Donald Lawrence Nelson, DDS

  • Dentist
  • Jamestown, NY
National Provider Identifier
1437373495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
028122 Issued in NY
Practice address
25 East Fourth Street
Fourth and Pine Building
Jamestown, NY 14701-5056
Phone
(716) 484-1887
Fax
(716) 484-9040
NPI assigned
Apr 12, 2007
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 028122 NY Primary

Addresses

Primary practice location

25 East Fourth Street
Fourth and Pine Building
Jamestown, NY 14701-5056

Mailing address

25 East Fourth Street
Fourth and Pine Building
Jamestown, NY 14701-5056
Phone (716) 484-1887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437373495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 EAST FOURTH STREET",
            "address_2": "FOURTH AND PINE BUILDING",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015056",
            "telephone_number": "716-484-1887",
            "fax_number": "716-484-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 EAST FOURTH STREET",
            "address_2": "FOURTH AND PINE BUILDING",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015056",
            "telephone_number": "716-484-1887",
            "fax_number": "716-484-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DONALD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "028122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.