Clay Dental Care of Central New York PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

37397 Issued in NY

Legal business name

CLAY DENTAL CARE OF CENTRAL NEW YORK PLLC

Practice address

3444 Rte 31
Baldwinsville, NY 13027-8333

Phone

(315) 652-3963

NPI assigned

Jul 25, 2007

Last updated

Dec 21, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert A Nicolais, D.D.S.NPI 1720290166

Title

Dentist/Owner

Phone

(315) 652-3963

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Robert A. Nicolais, D.D.S.

  • Dentist
  • Baldwinsville, NY
  • NPI 1720290166
  NPD (past) Authorized official
• Robert Fangio, D.D.S.

  • General Practice Dentistry
  • Baldwinsville, NY
  • NPI 1265657563
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513814400000",
    "number": "1689864803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 RTE 31",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130278333",
            "telephone_number": "315-652-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 RTE 31",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130278333",
            "telephone_number": "315-652-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY DENTAL CARE OF CENTRAL NEW YORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2017-12-21",
        "status": "A",
        "authorized_official_last_name": "NICOLAIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "315-652-3963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "37397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanne Christopher, LCSW
• Hao Chu, PSY.D.
• Llias W Chung
• Glynis Price Clark, RPH
• Clay CT, LLC
• Samantha Clemons, LMSW
• Carrigan Lee Cleveringa, M.S.
• Suzanne Theresa Clifton, L.P.N.
• Joan Coff, D.C.
• Matthew Coffey

• General Practice Dentistry in Baldwinsville, NY
• Providers in Baldwinsville, 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 Dec 21, 2017; 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.