Individual provider Active NPI

Yaelle Legallais, DMD

  • General Practice Dentistry
  • Latham, NY
National Provider Identifier
1477230175
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
064277 Issued in NY
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

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
064277NYMDGeneral 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.

Verify at the official NPI Registry.