MEDICARE: WEIDENFELD ENDODONTICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1184308116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEIDENFELD ENDODONTICS PLLC

Provider Business Mailing Address
First Line	:	138 STAGE RD
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-3513
Country	:	US
Telephone Number	:	845-928-5275
Fax Number	:

Provider Business Practice Location Address
First Line	:	138 STAGE RD
Second Line	:
City	:	MONROE
State	:	NY
Zip	:	10950-3513
Country	:	US
Telephone Number	:	845-928-5275
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALEX WEIDENFELD
Credential	:	DMD
Telephone Number	:	845-928-5275

Provider Enumeration Date	:	06/12/2023
Last Update Date	:	03/04/2026

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