Antonio Boncordo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0460501 Issued in NY

Practice address

515 1/2 Albany Shaker Rd
Loudonville, NY 12211

Phone

(518) 458-1320

Fax

(518) 458-9670

NPI assigned

Sep 12, 2006

Last updated

Jul 8, 2007By 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

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Abdentistrypllc

  • Dentist
  • Loudonville, NY
  • NPI 1265815088
  NPD (past) Authorized official

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831293562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 1/2 ALBANY SHAKER RD",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "12211",
            "telephone_number": "518-458-1320",
            "fax_number": "518-458-9670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 1/2 ALBANY SHAKER RD",
            "city": "LOUDONVILLE",
            "state": "NY",
            "postal_code": "12211",
            "telephone_number": "518-458-1320",
            "fax_number": "518-458-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONCORDO",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0460501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdentistrypllc
• Sailaja Alapati, MD
• Albany Advanced Dental Care
• Albany Shaker Dental (Lasting Impressions Dental)
• Ashok Baghel, MD
• Claudianus H Bourne, FNP
• Brandy Lawrence Licensed Massage Therapist, PLLC
• John Buddenhagen, DO
• Michelle Elizabeth Cafaro, RPA-C
• Capital Anesthesia, PLLC.

• General Practice Dentistry in Loudonville, NY
• Providers in Loudonville, 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 Jul 8, 2007; 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.