Michael Thomas Lavelle III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

039553 Issued in NY

Practice address

165 Whitesboro St
Yorkville, NY 13495-1322

Phone

(315) 736-7822

Fax

(315) 736-9432

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619049061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 WHITESBORO ST",
            "city": "YORKVILLE",
            "state": "NY",
            "postal_code": "134951322",
            "telephone_number": "315-736-7822",
            "fax_number": "315-736-9432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WHITESBORO ST",
            "city": "YORKVILLE",
            "state": "NY",
            "postal_code": "134951322",
            "telephone_number": "315-736-7822",
            "fax_number": "315-736-9432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliastaxtiand Transportation
• Michael M. Gus, PT
• Heritage Health Care Services
• Maria Alaina Klosek, LMHC
• Thomas Kupiec, L.AC
• Samantha Ann Miller, LPN
• Laura Emily Nasto
• Gita Patel, RPH
• Rakesh R Patel, R.PH.
• Erica Piazza, LCSW

• General Practice Dentistry in Yorkville, NY
• Providers in Yorkville, NY by specialty
• General Practice Dentistry in New York

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.