NPIMap

Organization Active NPI

Watkins Glen Family Dentistry P.L.L.C.

  • General Practice Dentistry
  • Watkins Glen, NY
National Provider Identifier
1831897396
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WATKINS GLEN FAMILY DENTISTRY P.L.L.C.
Practice address
703 S Decatur St
Watkins Glen, NY 14891-1614
Phone
(607) 535-4666
Fax
(607) 535-4287
NPI assigned
Feb 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

Name
Dr. Joshua Haentges, DDSNPI 1952854036
Title
Owner/President
Phone
(607) 535-4666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

703 S Decatur St
Watkins Glen, NY 14891-1614

Mailing address

703 S Decatur St
Watkins Glen, NY 14891-1614
Phone (607) 535-4666

Other names 1

  • Watkins Glen Family Dentistry and Implant Center Doing business as

National Provider Directory

National Provider Directory

Locations

703 S Decatur St
Watkins Glen, NY 14891
Phone (607) 535-4666

Practitioners & affiliated clinicians

Practitioners 3

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": "1677024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1831897396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 S DECATUR ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911614",
            "telephone_number": "607-535-4666",
            "fax_number": "607-535-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S DECATUR ST",
            "city": "WATKINS GLEN",
            "state": "NY",
            "postal_code": "148911614",
            "telephone_number": "607-535-4666",
            "fax_number": "607-535-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATKINS GLEN FAMILY DENTISTRY P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "HAENTGES",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "607-535-4666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watkins Glen Family Dentistry and Implant Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watkins Glen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.