NPIMap

Organization Active NPI

Szymczak and Evans Family General Dentistry, PC

Doing business as Pine Ridge Dental, PC

  • General Practice Dentistry
  • Duanesburg, NY
National Provider Identifier
1891333423
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SZYMCZAK AND EVANS FAMILY GENERAL DENTISTRY, PC
Doing business as
Pine Ridge Dental, PC
Practice address
6296 Duanesburg Road
Duanesburg, NY 12056
Phone
(518) 895-5288
Fax
(518) 895-5290
NPI assigned
Dec 13, 2019
Last updated
Dec 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Authorized official

Name
Dr. Don Patton Evans, DDS
Title
President
Phone
(518) 895-5288

Specialties & licenses 1

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

Addresses

Primary practice location

6296 Duanesburg Road
Duanesburg, NY 12056

Mailing address

6296 Duanesburg Road
PO Box 327
Duanesburg, NY 12056
Phone (518) 895-5288

Other names 1

  • Pine Ridge Dental, PC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1891333423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6296 DUANESBURG ROAD",
            "address_2": "PO BOX 327",
            "city": "DUANESBURG",
            "state": "NY",
            "postal_code": "12056",
            "telephone_number": "518-895-5288",
            "fax_number": "518-895-5290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6296 DUANESBURG ROAD",
            "city": "DUANESBURG",
            "state": "NY",
            "postal_code": "12056",
            "telephone_number": "518-895-5288",
            "fax_number": "518-895-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SZYMCZAK AND EVANS FAMILY GENERAL DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "PATTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-895-5288",
        "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": "Pine Ridge Dental, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duanesburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.