SILVER LAKE DENTAL PLLC (NPI# 1518265172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518265172 |
| Entity Type | Organization |
| Organization Name | SILVER LAKE DENTAL PLLC |
| Practice Address |
114 N Center St Perry NY 14530-9701 |
| Practice Telephone | 5852373530 |
| Practice Fax Number | 5852376651 |
| Mailing Telephone | 5852373530 |
| Mailing Fax Number | 5852376651 |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-03-07 |
| Authorized Official Name | DR. TIMOTHY J DERUYTER (MEMBER) |
| Authorized Official Telephone | 3155735031 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
055321 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982709390 | Silver Lake Dental Pllc | Dentist | 6176 N Government Way, Cour D Alene, ID 83815 | 2006-09-13 |
| 1851551345 | Silver Lake Dental Pllc | Dentist | 6176 N Government Way, Dalton Gardens, ID 83815-7331 | 2008-06-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SILVER LAKE DENTAL PLLC | 114 North Center Street, Perry, Ny 14530 |
| Street Address |
114 N CENTER ST |
| City | PERRY |
| State | NY |
| Zip Code | 14530-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548653900 | Kara Tress | Dentist | 114 N Center St, Perry, NY 14530-9701 | 2015-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306082615 | Terri Adair Humberstone | Speech-Language Pathologist | 7064 Standpipe Rd., Perry, NY 14530 | 2008-12-17 |
| 1740303353 | Lisa Kristine Hewitt | Registered Nurse | 36 South Center St, Perry, NY 14530 | 2007-04-09 |
| 1205961638 | Ralph Edward Field | Dentist | 114 North Center Street, Perry, NY 14530 | 2007-02-23 |
| 1821138249 | State of New York | Clinic/Center | 7059 Standpipe Dt, Perry, NY 14530 | 2007-02-07 |
| 1174766992 | Lindsey Stein | Dentist | 114 North Center Street, Perry, NY 14530 | 2009-04-09 |
| 1649395864 | Cynthia Sue Saar | Occupational Therapist | 7059 Standpipe Rd, Perry, NY 14530 | 2007-03-20 |
| 1285714576 | Jonathan David Ralph | Dentist | 78 S Main St, Perry, NY 14530 | 2006-10-17 |
| 1508836776 | Peter Privitera | Physical Therapist | 3 Handley St, Step By Step Physical Therapy PC, Perry, NY 14530 | 2006-01-23 |
| 1548497134 | Linda J Field | Registered Nurse | 2 Prospect St, Perry, NY 14530-1009 | 2009-06-22 |
| 1952420440 | Lori A Schofield | Specialist | 34 Benedict St, Perry, NY 14530-1118 | 2007-03-28 |
| Find all providers in zip 14530 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770748527 | Whitney James | Dentist | 708 Cedar St, Perry, OK 73077-6421 | 2008-07-22 |
| 1861697765 | Eric David Bryant | Dentist | 142 N Center St, Perry, NY 14530-9701 | 2007-06-19 |
| 1073727962 | T Craig Laughlin | Dentist | 2605 Iowa St, Perry, IA 50220-2413 | 2007-05-09 |
| 1114140175 | Louis C Shelton | Dentist | 1102 Morningside Dr, Perry, GA 31069-2906 | 2007-04-10 |
| 1013038934 | Melissa Renee Royer | Dentist | 7241 Lansing Rd, Perry, MI 48872-9743 | 2007-04-02 |
| 1265556138 | Robert Thomas Pierce | Dentist | 1021 Keith Dr, Perry, GA 31069-2948 | 2007-03-18 |
| 1104963032 | Temiko Graves Braswell | Dentist | 1133 Macon Rd, Perry, GA 31069-2651 | 2007-01-31 |
| 1396804142 | Neal B. Forbes | Dentist | 4543 N Ridge Rd, Perry, OH 44081-9738 | 2006-12-07 |
| 1447325667 | Gregory Dale Steffen | Dentist | 1305 2nd St, Perry, IA 50220-1511 | 2006-11-22 |
| 1548344757 | Joesph Warren Fuller IIi | Dentist | 1204 N Center St, Perry, FL 32347-2038 | 2006-10-24 |
| Find all providers in PERRY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.