Michael Thomas Guldan, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

041501 Issued in NY

Practice address

412 State Route 37
Hogansburg, NY 13655-3109

Phone

(518) 358-3141

Fax

(518) 358-6245

NPI assigned

Mar 27, 2006

Last updated

Mar 26, 2015By the provider in NPPES

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

Other identifiers 1

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

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1801856398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141",
            "fax_number": "518-358-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 STATE ROUTE 37",
            "city": "HOGANSBURG",
            "state": "NY",
            "postal_code": "136553109",
            "telephone_number": "518-358-3141",
            "fax_number": "518-358-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULDAN",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01242502",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefanie Katrina Davis, DDS
• Gracyn E. Denny, MSN, RN
• Wendy L Frank, FNP
• Amanda M Gardner, RN
• Sloan Gleason, LPN
• Wahienhawi Hall, LCSW
• Jesalyn Marie Hayes, RN
• Katherine R Henderson, LMHC, LCSW
• Mary M Herne, FNP-C
• Hillary Pyke (Mohawk Vision)

• General Practice Dentistry in Hogansburg, NY
• Providers in Hogansburg, 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 Mar 26, 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.