Active NPI
Allon Waltuch, DDS
- Dentist
- Woodmere, NY
National Provider Identifier
1891013371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0556201
- Practice address
- 37 Woodmere Blvd Apt 4a
Woodmere, NY 11598-2113 - Phone
- (516) 596-8854
- NPI assigned
- May 9, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0556201 | NY | Primary |
Addresses
Primary practice location
37 Woodmere Blvd Apt 4a
Woodmere, NY 11598-2113
Mailing address
125 N Wood LN
Woodmere, NY 11598-2123
Phone (516) 596-8854
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151218001866 | NY | Order and Referring Only - Dentist | 6204137136 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0556201 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425859200000",
"number": "1891013371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 N WOOD LN",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115982123",
"telephone_number": "516-596-8854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 WOODMERE BLVD APT 4A",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115982113",
"telephone_number": "516-596-8854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTUCH",
"first_name": "ALLON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-09",
"last_updated": "2015-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0556201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodmere, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.