Todd Mitchell Retell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41617 Issued in NY

Practice address

39 Elizabeth Dr
Lockport, NY 14094-5226

Phone

(716) 433-6004

NPI assigned

Oct 26, 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

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

Locations

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.

• Lockport Dental Group, P.C.

  • General Practice Dentistry
  • Lockport, NY
  • NPI 1154482818
  NPD Authorized official
• Medina Dental PLLC

  • Dentist
  • Medina, NY
  • NPI 1639576697
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1720163884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 SHARON DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140941314",
            "telephone_number": "716-439-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-433-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETELL",
        "first_name": "TODD",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "41617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selah Raybuck, RN
• Syed Zaeem Hussain Raza, DDS
• Red Fox Pharmacy, LLC.
• Liane M Reed, PHARMD
• Results Physical Therapy PLLC
• Jihane M Riad, D.D.S.
• Samantha Ribbeck
• Richard M Junke MD
• Glenn F Richards, RPH
• Lindsay Richardson, MSW

• General Practice Dentistry in Lockport, NY
• Providers in Lockport, 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 May 19, 2015; 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.