Jonathan David Vallecorsa

Primary specialty

DentistTaxonomy code 122300000X

License

062048 Issued in NY

Practice address

4 Sunset Dr
Latham, NY 12110-2104

Phone

(518) 785-5100

NPI assigned

Jun 9, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jvallecorsa788751@direct.trinity-health.org

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.

• David J. Vallecorsa DDS PLLC

  • General Practice Dentistry
  • Latham, NY
  • NPI 1043045461
  NPD

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1821613464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SUNSET DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102104",
            "telephone_number": "518-785-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SUNSET DR",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102104",
            "telephone_number": "518-785-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLECORSA",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-09",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Seating and Mobility LLC
• Maya Valentin, FNP
• Elizabeth Mary Valk, FNP-C
• David J Vallecorsa, DDS
• Gregory Michael Vallecorsa, D.D.S.
• Kim Stuart Van Der Veer, DC, CCSP
• Hoyte T Van Der Zee, M.D.
• Lucy Van Ness, RN
• Nancy Vanallen
• Paige Vanallen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.