Charles A Marchetta, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

034818-1 Issued in NY

Practice address

5755 Broadway St
Lancaster, NY 14086-2357

Phone

(716) 683-0891

NPI assigned

Nov 22, 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

Other identifiers 1

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

Practice roles

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.

• Lancaster Dental Associates, PC

  • General Practice Dentistry
  • Lancaster, NY
  • NPI 1437224698
  NPD (past) Authorized official

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669547881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 HILLCREST RD",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140521312",
            "telephone_number": "716-652-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 BROADWAY ST",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140862357",
            "telephone_number": "716-683-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHETTA",
        "first_name": "CHARLES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034818-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00613754",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Maciag, COTA
• Annette M. Majchrzak, R.N.
• Gary Joseph Majkowski, D.C.
• Traci Ann Mangold, RPH
• Franco Antonio Marcello, D.C.
• Joleen Elizabeth Marfone, DC
• Felicia Martinez
• Rosalie Bianca Mattison
• Brian Anthony Matuszak, O.D
• Giovanni Maurice, RN

• General Practice Dentistry in Lancaster, NY
• Providers in Lancaster, 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 9, 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.