Upstate New York Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

056567-1 Issued in NY

Legal business name

UPSTATE NEW YORK DENTAL PC

Doing business as

Wilson Dental

Practice address

30 W State St
Binghamton, NY 13901-2332

Phone

(607) 238-1280

NPI assigned

Dec 6, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Nanarao Krothapalli, DMD

Title

Dentist

Phone

(617) 223-1652

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WILSON DENTAL Doing business as

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1912338674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W STATE ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139012332",
            "telephone_number": "607-238-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W STATE ST",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139012332",
            "telephone_number": "607-238-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE NEW YORK DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "KROTHAPALLI",
        "authorized_official_first_name": "NANARAO",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "617-223-1652",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "056567-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03586427",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WILSON DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Paul Uppal, M.D.
• Hamza Usman, MD
• Lorrie L Vail, NP
• Claudia Valdez, LMSW
• Christoper Valenti, MD
• Marianne Valenzuela, FNP

• Dentist in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.