Adirondack Family Dentistry PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0474861 Issued in NY

Legal business name

ADIRONDACK FAMILY DENTISTRY PC

Practice address

7990 State Rte 12
Suite 1
Barneveld, NY 13304

Phone

(315) 896-7293

Fax

(315) 896-7294

NPI assigned

Nov 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Everett M Stalker, DDSNPI 1821163510

Title

Owner Vice President

Phone

(315) 896-7293

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Everett M Stalker, DDS

  • General Practice Dentistry
  • Barneveld, NY
  • NPI 1821163510
  NPD (past) Authorized official

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861567554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7990 STATE RTE 12",
            "address_2": "SUITE 1",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "13304",
            "telephone_number": "315-896-7293",
            "fax_number": "315-896-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7990 STATE RTE 12",
            "address_2": "SUITE 1",
            "city": "BARNEVELD",
            "state": "NY",
            "postal_code": "13304",
            "telephone_number": "315-896-7293",
            "fax_number": "315-896-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADIRONDACK FAMILY DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STALKER",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER VICE PRESIDENT",
        "authorized_official_telephone_number": "315-896-7293",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0474871",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0474861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathryn Baillie

• General Practice Dentistry in Barneveld, NY
• Providers in Barneveld, 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 Aug 22, 2020; 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.