Individual provider Active NPI

Margaret M Pazzaglia Adolf, DDS

  • Dentist
  • Buffalo, NY
National Provider Identifier
1194940825
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0434361 Issued in NY
Practice address
2121 Main St Ste 310
Buffalo, NY 14214-2671
Phone
(716) 832-3108
Fax
(716) 832-0683
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0434361 NY Primary

Addresses

Primary practice location

2121 Main St Ste 310
Buffalo, NY 14214-2671

Mailing address

2121 Main Street
Suite 310
Buffalo, NY 14214-2670
Phone (716) 832-3108

Other identifiers 1

IdentifierTypeStateIssuer
02148089MedicaidNY

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
I20150610001822 NY Order and Referring Only - DentistPractitioner - Dentist 5193046555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0434361NYMDDentist
043436NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Dental Associates Past 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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1194940825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 MAIN STREET",
            "address_2": "SUITE 310",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142670",
            "telephone_number": "716-832-3108",
            "fax_number": "716-832-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 MAIN ST STE 310",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142671",
            "telephone_number": "716-832-3108",
            "fax_number": "716-832-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAZZAGLIA ADOLF",
        "first_name": "MARGARET",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0434361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02148089",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.