Individual provider Active NPI

Gilbert Harold Schulenberg, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Buffalo, NY
National Provider Identifier
1124084389
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
034462 Issued in NY
Practice address
117 Linwood Ave
Buffalo, NY 14209-2003
Phone
(716) 882-6333
Fax
(716) 882-0891
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 034462 NY Primary

Addresses

Primary practice location

117 Linwood Ave
Buffalo, NY 14209-2003

Mailing address

117 Linwood Ave
Buffalo, NY 14209-2003
Phone (716) 882-6333

Other identifiers 1

IdentifierTypeStateIssuer
00760352MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110127000787 NY Practitioner - Maxillofacial Surgery 6507045135

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Buffalo Oral Surgery Specialists PLLC PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 1

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1124084389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092003",
            "telephone_number": "716-882-6333",
            "fax_number": "716-882-0891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092003",
            "telephone_number": "716-882-6333",
            "fax_number": "716-882-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULENBERG",
        "first_name": "GILBERT",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "034462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00760352",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.