Organization Active NPI

Orthodontic Group of the Fingerlakes PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ithaca, NY
National Provider Identifier
1851805964
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC GROUP OF THE FINGERLAKES PLLC
Practice address
412 N Tioga St
Ithaca, NY 14850-4256
Phone
(607) 272-3921
NPI assigned
Nov 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mark A Paciorek, DDS
Title
President
Phone
(607) 272-3921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

412 N Tioga St
Ithaca, NY 14850-4256

Mailing address

412 N Tioga St
Ithaca, NY 14850-4256

Other practice location 1

18 Church St
Cortland, NY 13045-2886
Phone (607) 753-3371

National Provider Directory

National Provider Directory

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": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1851805964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N TIOGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N TIOGA ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148504256",
            "telephone_number": "607-272-3921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Church St",
            "address_purpose": "LOCATION",
            "city": "Cortland",
            "state": "NY",
            "postal_code": "130452886",
            "country_code": "US",
            "telephone_number": "607-753-3371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ORTHODONTIC GROUP OF THE FINGERLAKES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "PACIOREK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-272-3921",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.