Individual provider Active NPI

Sarah Reiss, DDS

  • General Practice Dentistry
  • Schenectady, NY
National Provider Identifier
1194945295
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
043633 Issued in NY
Practice address
1365 Van Antwerp Rd
Schenectady, NY 12309-4441
Phone
(518) 641-1577
Fax
(518) 393-8606
NPI assigned
Apr 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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 043633 NY Primary

Addresses

Primary practice location

1365 Van Antwerp Rd
Schenectady, NY 12309-4441

Mailing address

1365 Van Antwerp Rd
Schenectady, NY 12309-4441
Phone (518) 641-1577

Other identifiers 1

IdentifierTypeStateIssuer
00357548MedicaidNY

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
I20190128001966 NY Order and Referring Only - DentistPractitioner - Dentist 1254678337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043633NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1194945295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 VAN ANTWERP RD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123094441",
            "telephone_number": "518-641-1577",
            "fax_number": "518-393-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 VAN ANTWERP RD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123094441",
            "telephone_number": "518-641-1577",
            "fax_number": "518-393-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISS",
        "first_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "043633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00357548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.