Eden Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

054389 Issued in NY

Legal business name

EDEN FAMILY DENTAL PLLC

Practice address

2763 W Church St
Eden, NY 14057-1012

Phone

(716) 992-9511

NPI assigned

Jan 31, 2016

Last updated

Jan 31, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirsten Riester, DDS

Title

Owner

Phone

(716) 992-9511

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454198400000",
    "number": "1487012837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 W CHURCH ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140571012",
            "telephone_number": "716-992-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2763 W CHURCH ST",
            "city": "EDEN",
            "state": "NY",
            "postal_code": "140571012",
            "telephone_number": "716-992-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-31",
        "last_updated": "2016-01-31",
        "status": "A",
        "authorized_official_last_name": "RIESTER",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-992-9511",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter John Demarco Jr., DDS
• Deborah Dibble, FNP
• Eckerd Corporation (Rite Aid Pharmacy 10813)
• Eden Central School District
• Eden Emergency Squad Inc
• Eden Heights of Eden Operating, LLC
• Eden Primary Care
• Edrnc Operating LLC (Eden Rehabilitation and Nursing Center)
• Family Plus Primary Care,Rpa,PC
• Dana L. Fazzolari

• Dentist in Eden, NY
• Providers in Eden, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2016; 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.