NPIMap

Organization Active NPI

Mark Twichell & Annette Lukasik DDS LLP

  • Pediatric Dentistry
  • Fredonia, NY
National Provider Identifier
1588845416
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0456561 Issued in NY
Legal business name
MARK TWICHELL & ANNETTE LUKASIK DDS LLP
Practice address
85 West Main Street
Fredonia, NY 14063
Phone
(716) 672-2854
Fax
(716) 672-5269
NPI assigned
Nov 20, 2007
Last updated
Nov 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Authorized official

Name
Dr. Mark L Twichell, DDSNPI 1669410015
Title
Pediatric Dentist
Phone
(716) 672-2854

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 0456561 NY Primary

Addresses

Primary practice location

85 West Main Street
Fredonia, NY 14063

Mailing address

85 West Main Street
Fredonia, NY 14063
Phone (716) 672-2854

Other identifiers 2

IdentifierTypeStateIssuer
01549233MedicaidNY
02881670MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1588845416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 WEST MAIN STREET",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "14063",
            "telephone_number": "716-672-2854",
            "fax_number": "716-672-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WEST MAIN STREET",
            "city": "FREDONIA",
            "state": "NY",
            "postal_code": "14063",
            "telephone_number": "716-672-2854",
            "fax_number": "716-672-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK TWICHELL & ANNETTE LUKASIK DDS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "TWICHELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "716-672-2854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "0456561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01549233",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02881670",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredonia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.