PEDIATRIC DENTISTRY OF ALBANY PLLC NPI 1457039190

NPI Information

  • NPI: 1457039190
  • Provider Name: PEDIATRIC DENTISTRY OF ALBANY, PLLC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Doing Business As: PEDIATRIC DENTISTRY OF SCHENECTADY
  • Address: 624 MCCLELLAN ST STE G03
    SCHENECTADY, NY
    ZIP 12304
  • Phone: (518) 512-3072

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NPI Details

PEDIATRIC DENTISTRY OF ALBANY, PLLC is a pediatric dentistry dentist in Schenectady, NY. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEDIATRIC DENTISTRY OF ALBANY, PLLC NPI is 1457039190. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pediatric Dentistry Of Schenectady.

The provider's business location address is:

624 MCCLELLAN ST STE G03
SCHENECTADY, NY
ZIP 12304-020
Phone: (518) 512-3072
Fax: (518) 621-7286

The provider's authorized official is Barry L Jacobson .
The authorized official title is Ceo and has the following contact phone number (845) 369-3703.

The enumeration date for this NPI number is 7/11/2023 and was last updated on 7/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223D0004XDentistDentist AnesthesiologistNo
21223G0001XDentistGeneral PracticeNo
31223S0112XDentistOral and Maxillofacial SurgeryNo
41223X0400XDentistOrthodontics and Dentofacial OrthopedicsNo
51223P0221XDentistPediatric DentistryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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