Individual provider Active NPI

Jenna Sinclair Sauter

  • General Practice Dentistry
  • Buffalo, NY
National Provider Identifier
1083346613
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
063476 Issued in NY
Practice address
155 Lawn Ave
Buffalo, NY 14207-1816
Phone
(716) 875-2904
Fax
(716) 875-6717
NPI assigned
Jun 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 063476 NY Primary

Addresses

Primary practice location

155 Lawn Ave
Buffalo, NY 14207-1816

Mailing address

155 Lawn Ave
Buffalo, NY 14207-1816
Phone (716) 875-2904

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240208002132 NY Practitioner - Dentist 8022451806 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063476NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Health Center of Wny, Inc. CurrentSince Dec 4, 2023 Accepting new patients
Neighborhood Health Center of Wny, Inc. CurrentSince Dec 4, 2023 Accepting new patients

Locations

155 Lawn Ave
Buffalo, NY 14207
Phone (716) 875-2904

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1083346613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 LAWN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071816",
            "telephone_number": "716-875-2904",
            "fax_number": "716-875-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 LAWN AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142071816",
            "telephone_number": "716-875-2904",
            "fax_number": "716-875-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUTER",
        "first_name": "JENNA",
        "middle_name": "SINCLAIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "063476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.