Organization Active NPI

Wojtyna Dental LLC

  • Dentist
  • East Syracuse, NY
National Provider Identifier
1437690104
Registry record updated Mar 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019027575 Issued in IL
Legal business name
WOJTYNA DENTAL LLC
Practice address
6600 Weighlock Drive
East Syracuse, NY 13057
Phone
(315) 454-6000
Fax
(866) 803-4943
NPI assigned
Mar 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2017

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

Authorized official

Name
Heather Kraushaar
Title
Provider Relations
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019027575 IL Primary

Addresses

Primary practice location

6600 Weighlock Drive
East Syracuse, NY 13057

Mailing address

3024 Sr-159
Glen Carbon, IL 62034
Phone (618) 205-6119

National Provider Directory

National Provider Directory

Locations

3024 S State Route 159
Glen Carbon, IL 62034
Phone (618) 205-6119

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489536000000",
    "number": "1437690104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 SR-159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "62034",
            "telephone_number": "618-205-6119",
            "fax_number": "618-659-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 WEIGHLOCK DRIVE",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-454-6000",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOJTYNA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A",
        "authorized_official_last_name": "KRAUSHAAR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PROVIDER RELATIONS",
        "authorized_official_telephone_number": "315-454-6000"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; 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.