Jennifer Ann Holmer Su, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

049550-1 Issued in NY

Practice address

1950 Sheridan Dr
#5
Buffalo, NY 14223-1240

Phone

(716) 875-3660

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baker Victory Healthcare Center

  • Dentist
  • Lackawanna, NY
  • NPI 1619191855
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073554291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 CROWN ROYAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212764",
            "telephone_number": "716-689-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SHERIDAN DR",
            "address_2": "#5",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142231240",
            "telephone_number": "716-875-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMER SU",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049550-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Holloway
• Nicole Holloway, LMHC
• Amanda Lee Holman, DPT
• Tharon B. Holmberg, CRNP
• Juliet Maureen Holme
• Amy Holmer
• Anna Holmes
• Charisma Holmes
• David M Holmes, MD
• Katherine Marie Holmes

• Dentist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.