Active NPI
Yaelle Legallais, DMD
- General Practice Dentistry
- Latham, NY
National Provider Identifier
1477230175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 064277
- Practice address
- 231 Wade Road Ext Ste 101
Latham, NY 12110-1855 - Phone
- (518) 782-1900
- NPI assigned
- Jul 3, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 064277 | NY | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
231 Wade Road Ext Ste 101
Latham, NY 12110-1855
Mailing address
354 Rue Sherbrooke E
Montreal, QUEBEC H2X 1E6
CA
Other practice location 1
1710 Altamont Ave Ste 2
Schenectady, NY 12303-2184
Phone (518) 957-5677
Other practice location 2
111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 064277 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1477230175",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "354 RUE SHERBROOKE E",
"city": "MONTREAL",
"state": "QUEBEC",
"postal_code": "H2X 1E6"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 WADE ROAD EXT STE 101",
"city": "LATHAM",
"state": "NY",
"postal_code": "121101855",
"telephone_number": "518-782-1900"
}
],
"practiceLocations": [
{
"address_1": "1710 Altamont Ave Ste 2",
"address_purpose": "LOCATION",
"city": "Schenectady",
"state": "NY",
"postal_code": "123032184",
"country_code": "US",
"telephone_number": "518-957-5677",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 E 210th St",
"address_purpose": "LOCATION",
"city": "Bronx",
"state": "NY",
"postal_code": "104672401",
"country_code": "US",
"telephone_number": "718-920-4321",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEGALLAIS",
"first_name": "YAELLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "064277",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.