1. Home
  2. Directory
  3. New York
  4. Fredonia
  5. Dentist
  6. NPI Profile

FREDONIA PEDIATRIC AND ADOLESCENT DENTISTRY PLLC
NPI 1558811646
Dentist - Pediatric Dentistry in Fredonia, NY

Active since October 12, 2016
10433 CHRISTY RD, FREDONIA, NY 14063(716) 672-2854(716) 672-5269 Get Directions Write a Review

NPPES record last updated: October 15, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 15, 2019, Oct 12, 2016 (2 updates tracked since 2016).

About Fredonia Pediatric And Adolescent Dentistry Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDONIA PEDIATRIC AND ADOLESCENT DENTISTRY PLLC (NPI 1558811646) is a healthcare organization registered as a pediatric dentistry in Fredonia, New York and active in the NPI registry since October 2016. The organization lists Antoinette Lukasik, Pediatric Dentist, as its authorized official.

NPPES Registry Identity

NPI1558811646
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameFREDONIA PEDIATRIC AND ADOLESCENT DENTISTRY PLLC
Location Address10433 CHRISTY RDFredonia, NY 14063-9788
Mailing Address10433 Christy RdFredonia, NY 14063-9788 · (716) 672-2854 · Fax (716) 672-5269
Phone(716) 672-2854
Fax(716) 672-5269
Organization SubpartNo
Authorized OfficialAntoinette LukasikPediatric Dentist · (716) 672-2854
Enumeration DateOctober 12, 2016
Last NPPES UpdateOctober 15, 20192 updates tracked since enumeration
✔ NPI 1558811646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
License✔ Licensed in NY · 045656
Definition
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.
10433 CHRISTY RD, Fredonia, NY 14063
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fredonia Pediatric And Adolescent Dentistry PLLC's NPI number?

The NPI number for Fredonia Pediatric And Adolescent Dentistry PLLC is 1558811646. It was assigned to this organization in the NPPES registry on October 12, 2016.

Where is Fredonia Pediatric And Adolescent Dentistry PLLC located?

Fredonia Pediatric And Adolescent Dentistry PLLC is located at 10433 Christy Rd, Fredonia, NY 14063. The listed phone number is (716) 672-2854.

What is Fredonia Pediatric And Adolescent Dentistry PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Fredonia Pediatric And Adolescent Dentistry PLLC was last updated on October 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.