Individual provider Active NPI

Eric E Vetter, DDS

  • Dentist
  • Williamsville, NY
National Provider Identifier
1659416063
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
031650 Issued in NY
Practice address
2809 Wehrle Dr
Suite 11
Williamsville, NY 14221-7380
Phone
(716) 626-0250
Fax
(716) 626-0253
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 031650 NY Primary

Addresses

Primary practice location

2809 Wehrle Dr
Suite 11
Williamsville, NY 14221-7380

Mailing address

2809 Wehrle Dr
Suite 11
Williamsville, NY 14221-7380
Phone (716) 626-0250

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160310002127 NY Order and Referring Only - DentistPractitioner - Dentist 2961708359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031650NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659416063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 WEHRLE DR",
            "address_2": "SUITE 11",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217380",
            "telephone_number": "716-626-0250",
            "fax_number": "716-626-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 WEHRLE DR",
            "address_2": "SUITE 11",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217380",
            "telephone_number": "716-626-0250",
            "fax_number": "716-626-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VETTER",
        "first_name": "ERIC",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "031650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.