Active NPI
Joan C. Laura, DDS
- General Practice Dentistry
- Syracuse, NY
National Provider Identifier
1477646628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 042283
- Practice address
- 2326 James St
Syracuse, NY 13206-2839 - Phone
- (315) 438-3333
- Fax
- (315) 437-7276
- NPI assigned
- Oct 2, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 042283 | NY | Primary |
Addresses
Primary practice location
2326 James St
Syracuse, NY 13206-2839
Mailing address
2326 James St
Syracuse, NY 13206-2839
Phone (315) 438-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2GH | Medicaid | NY |
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 |
|---|---|---|---|
| 042283 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastwood Dental Office, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Syracuse, NY
- NPI 1417049198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477646628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2326 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132062839",
"telephone_number": "315-438-3333",
"fax_number": "315-437-7276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2326 JAMES ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132062839",
"telephone_number": "315-438-3333",
"fax_number": "315-437-7276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAURA",
"first_name": "JOAN",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "042283",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2GH",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, 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.