Michael Joseph Connelly, DMD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Yorktown Heights, NY
NPI 1720142839 · NPPES record last updated Aug 6, 2007
Key facts
- NPI
- 1720142839
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 049965 (NY)
- Practice address
- 206 Veterans Rd
Suite #5
Yorktown Heights, NY 10598-4106 - Phone
- (914) 962-5566
- Fax
- (914) 962-6010
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 26, 2016 through Apr 26, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alan R. Schadlow, M.D., P.C. | Past | Accepting new patients | |
| Yorktown Dental Group LLP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 049965 | NY | Yes |
Addresses
Primary practice location
206 Veterans Rd
Suite #5
Yorktown Heights, NY 10598-4106
Mailing address
206 Veterans Rd
Suite #5
Yorktown Heights, NY 10598-4106
Phone (914) 962-5566
Other providers in Yorktown Heights, NY
- Bridget Lucille Coccaro
- Cohen Pediatric Dentistry, PC
- Christopher C Colasuonno
- William L Collins
- Community Based Services, Inc.
- Kathryn Contento
- Convenient Care Medical
- Lizbeth Conway
- Darlene Troia Cook
- Laura Cordella
All providers in Yorktown Heights, NY · Orthodontics and Dentofacial Orthopedics Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.