Individual provider Active NPI

Emily Kathleen Walsh, DDS

  • General Practice Dentistry
  • Lagrangeville, NY
National Provider Identifier
1902467244
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
062435 Issued in NY
Practice address
1110 State Route 55 Ste 107
Lagrangeville, NY 12540-5048
Phone
(845) 486-4572
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES.004083 OH
Dentist 122300000X 30.026095 OH
General Practice Dentistry 1223G0001X 062435 NY Primary

Addresses

Primary practice location

1110 State Route 55 Ste 107
Lagrangeville, NY 12540-5048

Mailing address

1110 State Route 55 Ste 107
Lagrangeville, NY 12540-5048
Phone (845) 486-4572

Other practice location 1

1320 Mercy Dr NW
Canton, OH 44708-2614
Phone (330) 471-5950

Other practice location 2

4550 Belden Village St NW
Canton, OH 44718-2524
Phone (330) 499-4600

Other practice location 3

545 E Aurora Rd
Macedonia, OH 44056-1837
Phone (330) 331-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30.026095OHMDDentist
RES.004083OHMDDentist
062435NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilkie Paes, DDS PC General Practice CurrentSince Dec 17, 2023 Accepting new patients
Singular Anesthesia Services, PLLC PastSince Nov 13, 2022 Accepting new patients

Locations

1110 State Route 55
Ste 107
Lagrangeville, NY 12540
Phone (845) 320-5262

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1902467244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 STATE ROUTE 55 STE 107",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405048",
            "telephone_number": "845-486-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 STATE ROUTE 55 STE 107",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405048",
            "telephone_number": "845-486-4572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Mercy Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447082614",
            "country_code": "US",
            "telephone_number": "330-471-5950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4550 Belden Village St NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447182524",
            "country_code": "US",
            "telephone_number": "330-499-4600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "545 E Aurora Rd",
            "address_purpose": "LOCATION",
            "city": "Macedonia",
            "state": "OH",
            "postal_code": "440561837",
            "country_code": "US",
            "telephone_number": "330-331-0125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSH",
        "first_name": "EMILY",
        "middle_name": "KATHLEEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.004083",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026095",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrangeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.