Organization Active NPI

Williamsville Family Dentistry P.C.

  • Dentist
  • Williamsville, NY
National Provider Identifier
1942479308
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052390-1 Issued in NY
Legal business name
WILLIAMSVILLE FAMILY DENTISTRY P.C.
Practice address
1630 Maple Rd
Williamsville, NY 14221-3706
Phone
(716) 568-2273
Fax
(716) 568-2047
NPI assigned
Feb 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Dr. Kevin G Clauser, D.D.S.
Title
Dentist
Phone
(716) 568-2273

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 052390-1 NY Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 053497 NY

Addresses

Primary practice location

1630 Maple Rd
Williamsville, NY 14221-3706

Mailing address

1630 Maple Rd
Williamsville, NY 14221-3706
Phone (716) 568-2273

Other identifiers 2

IdentifierTypeStateIssuer
02883347MedicaidNY
02783677MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1942479308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213706",
            "telephone_number": "716-568-2273",
            "fax_number": "716-568-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MAPLE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213706",
            "telephone_number": "716-568-2273",
            "fax_number": "716-568-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSVILLE FAMILY DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "CLAUSER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "716-568-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "052390-1",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "053497",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02883347",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02783677",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 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.