Active NPI
Michael J Fidler, DDS
- Oral and Maxillofacial Pathology Dentistry
- Binghamton, NY
National Provider Identifier
1568468130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Pathology Dentistry
- License
- 030712
- Practice address
- 161 Riverside Dr
Ste 201
Binghamton, NY 13905-4178 - Phone
- (607) 798-7169
- Fax
- (607) 798-9204
- NPI assigned
- Jun 28, 2005
- Reactivated
- Mar 28, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 030712 | NY | Primary |
Addresses
Primary practice location
161 Riverside Dr
Ste 201
Binghamton, NY 13905-4178
Mailing address
161 Riverside Dr
Ste 201
Binghamton, NY 13905-4178
Phone (607) 798-7169
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00554912 | Medicaid | NY |
Other names 1
- Mr. Michael J Fidler
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 |
|---|---|---|---|
| 030712 | NY | MD | Oral and Maxillofacial Pathology Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark a Dreher DDS MD PC | Past | Accepting new patients | |
| Oral Surgery Associates | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Oral and Maxillofacial Surgery (Dentist)
- Binghamton, NY
- NPI 1639216690
-
- Dentist
- Binghamton, NY
- NPI 1033366083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1568468130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 RIVERSIDE DR",
"address_2": "STE 201",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139054178",
"telephone_number": "607-798-7169",
"fax_number": "607-798-9204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 RIVERSIDE DR",
"address_2": "STE 201",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139054178",
"telephone_number": "607-798-7169",
"fax_number": "607-798-9204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIDLER",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2026-07-13",
"deactivation_date": "2006-03-17",
"reactivation_date": "2006-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "NY",
"license": "030712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00554912",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICHAEL",
"last_name": "FIDLER",
"middle_name": "J",
"prefix": "MR.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.