Organization Active NPI

Walton Dental PLLC

  • General Practice Dentistry
  • Walton, NY
National Provider Identifier
1790971869
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49385 Issued in NY
Legal business name
WALTON DENTAL PLLC
Practice address
132 Delaware St
Walton, NY 13856-1331
Phone
(607) 865-4000
NPI assigned
Sep 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Maksim Lyubarskiy
Title
Owner
Phone
(607) 865-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 49385 NY Primary

Addresses

Primary practice location

132 Delaware St
Walton, NY 13856-1331

Mailing address

132 Delaware St
Walton, NY 13856-1331
Phone (607) 865-4000

National Provider Directory

National Provider Directory

Locations

132 Delaware St
Walton, NY 13856
Phone (607) 865-4000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1790971869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561331",
            "telephone_number": "607-865-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 DELAWARE ST",
            "city": "WALTON",
            "state": "NY",
            "postal_code": "138561331",
            "telephone_number": "607-865-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTON DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "LYUBARSKIY",
        "authorized_official_first_name": "MAKSIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-865-4000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "49385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.