Evan Conley, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

063200 Issued in NY

Practice address

233 East Ave
Lockport, NY 14094-3812

Phone

(716) 434-1900

NPI assigned

Apr 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Erie County Medical Center Corporation

  • Clinic/Center
  • Buffalo, NY
  • NPI 1528233616
  Medicare reassignment NPD
• Erie County Medical Center Corporation

  • Community/Retail Pharmacy
  • Buffalo, NY
  • NPI 1922768621
  NPD

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1730820663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 EAST AVE",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140943812",
            "telephone_number": "716-434-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 Grider St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142153021",
            "country_code": "US",
            "telephone_number": "716-898-3189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONLEY",
        "first_name": "EVAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063200",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luann Coleman, RN
• Maryellen D Colling, CCC/SLP
• Community Pediatrics of Wny, PLLC
• John Richard Comstock, PHYSICAL THERAPIST
• Charlene L Conley, FNP
• Joseph F Corigliano, DO
• Mark Joseph Costello, PT
• Mary Jo Costello, LMT
• Council Opticians of Lockport Inc
• County of Niagara

• Dentist in Lockport, NY
• Providers in Lockport, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.