Active NPI
Casondra Ruth McDermott, RDH
- Dental Hygienist
- Syracuse, NY
National Provider Identifier
1780972489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 025736-1
- Practice address
- 819 S Salina St
Syracuse, NY 13202-3527 - Phone
- (315) 476-7921
- Fax
- (315) 475-1448
- NPI assigned
- Jul 14, 2011
- 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 Hygienist | 124Q00000X | 025736-1 | NY | Primary |
Addresses
Primary practice location
819 S Salina St
Syracuse, NY 13202-3527
Mailing address
819 S Salina St
Syracuse, NY 13202-3527
Phone (315) 476-7921
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 |
|---|---|---|---|
| 025736-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473379200000",
"number": "1780972489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 S SALINA ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132023527",
"telephone_number": "315-476-7921",
"fax_number": "315-475-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 S SALINA ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132023527",
"telephone_number": "315-476-7921",
"fax_number": "315-475-1448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "CASONDRA",
"middle_name": "RUTH",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-14",
"last_updated": "2016-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NY",
"license": "025736-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.