ADIRONDACK PERIODONTICS PLLC
NPI 1689816274
Clinic/Center - Dental in Plattsburgh, NY
About Adirondack Periodontics Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ADIRONDACK PERIODONTICS PLLC (NPI 1689816274) is a healthcare organization registered as a dental in Plattsburgh, New York and active in the NPI registry since March 2009. The organization lists Gordon H Davis, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Adirondack Periodontics Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Adirondack Periodontics PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Adirondack Periodontics PLLC's NPI number?
The NPI number for Adirondack Periodontics PLLC is 1689816274. It was assigned to this organization in the NPPES registry on March 30, 2009.
Where is Adirondack Periodontics PLLC located?
Adirondack Periodontics PLLC is located at 4161 Route 22, Plattsburgh, NY 12901. The listed phone number is (518) 563-0040.
What is Adirondack Periodontics PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.
Is Adirondack Periodontics PLLC enrolled in Medicare?
Yes. Adirondack Periodontics PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Adirondack Periodontics PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Adirondack Periodontics PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Adirondack Periodontics PLLC was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Adirondack Periodontics Pllc · NPI 1689816274
Dental organization in Plattsburgh, New York. Organization record, active in the CMS NPPES registry since March 30, 2009.
## Identity
- **NPI:** 1689816274 (Entity type: Organization)
- **Enumerated:** March 30, 2009
- **Primary specialty:** Clinic/Center - Dental · taxonomy 261QD0000X
- **Organization subpart:** No
- **Authorized official:** Gordon Davis, OWNER
## Practice location
- **Address:** 4161 ROUTE 22, Plattsburgh, NY 12901-5883
- **Phone:** (518) 563-0040 · **Fax:** (518) 562-0632
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Oral Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1689816274) · Data from the CMS NPPES public registry.