NPIMap

Organization Active NPI

Edward D Long III DDS PC

  • Dentist
  • Kenmore, NY
National Provider Identifier
1679678668
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
032217 Issued in NY
Legal business name
EDWARD D LONG III DDS PC
Practice address
1895 Sheridan Drive
Kenmore, NY 14223-1201
Phone
(716) 874-6363
Fax
(716) 874-6700
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Edward D Long III, DDSNPI 1770606345
Title
President
Phone
(716) 874-6363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 032217 NY Primary

Addresses

Primary practice location

1895 Sheridan Drive
Kenmore, NY 14223-1201

Mailing address

1895 Sheridan Drive
Kenmore, NY 14223-1201
Phone (716) 874-6363

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679678668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 SHERIDAN DRIVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142231201",
            "telephone_number": "716-874-6363",
            "fax_number": "716-874-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 SHERIDAN DRIVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142231201",
            "telephone_number": "716-874-6363",
            "fax_number": "716-874-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD D LONG III DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-874-6363",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "032217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.