Organization Active NPI

Capital Region Dentistry and Oral Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Albany, NY
National Provider Identifier
1487349361
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
CAPITAL REGION DENTISTRY AND ORAL SURGERY, PLLC
Practice address
10 Airline Dr Ste 204
Albany, NY 12205-1025
Phone
(518) 456-6104
NPI assigned
Apr 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

Name
Emily Maisch
Title
Practice Administrator
Phone
(845) 430-9394

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

10 Airline Dr Ste 204
Albany, NY 12205-1025

Mailing address

10 Airline Dr Ste 204
Albany, NY 12205-1025
Phone (518) 456-6104

Other names 1

  • Reilly Gelder OMS Doing business as

National Provider Directory

National Provider Directory

Locations

10 Airline Dr
Ste 204
Albany, NY 12205
Phone (518) 456-6104

Practitioners & affiliated clinicians

Practitioners 1

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": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1487349361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 AIRLINE DR STE 204",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051025",
            "telephone_number": "518-456-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 AIRLINE DR STE 204",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051025",
            "telephone_number": "518-456-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL REGION DENTISTRY AND ORAL SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "MAISCH",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "845-430-9394"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reilly Gelder OMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; 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.