Active NPI
Julie A Hanavan, CDA
- Dental Assistant
- Lackawanna, NY
National Provider Identifier
1740447663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 000804
- Practice address
- 790 Ridge Rd
Lackawanna, NY 14218 - Phone
- (716) 828-9344
- NPI assigned
- May 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 000804 | NY | Primary |
Addresses
Primary practice location
790 Ridge Rd
Lackawanna, NY 14218
Mailing address
259 Emporium Ave
West Seneca, NY 14224
Phone (716) 827-5635
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000804 | NY | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1740447663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 EMPORIUM AVE",
"city": "WEST SENECA",
"state": "NY",
"postal_code": "14224",
"telephone_number": "716-827-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 RIDGE RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "14218",
"telephone_number": "716-828-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANAVAN",
"first_name": "JULIE",
"middle_name": "A",
"credential": "CDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "NY",
"license": "000804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lackawanna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.