Tony'S Comfort Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

049131 Issued in NY

Legal business name

TONY'S COMFORT DENTAL PC

Practice address

154 Cazenovia St
Buffalo, NY 14210-2436

Phone

(716) 823-3030

NPI assigned

May 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Gaetano Petrilli, DDS

Title

President

Phone

(716) 823-3030

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1871751156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 CAZENOVIA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142102436",
            "telephone_number": "716-823-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 CAZENOVIA ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142102436",
            "telephone_number": "716-823-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TONY'S COMFORT DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "PETRILLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "GAETANO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-823-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02658304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.