Active NPI
Michael R Gburek, D.D.S.
- General Practice Dentistry
- Warsaw, NY
National Provider Identifier
1235253840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 039311-1
- Practice address
- 34 Duncan St
Warsaw, NY 14569-1017 - Phone
- (585) 786-3676
- Fax
- (585) 786-3896
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 039311-1 | NY | Primary |
Addresses
Primary practice location
34 Duncan St
Warsaw, NY 14569-1017
Mailing address
34 Duncan St
Warsaw, NY 14569-1017
Phone (585) 786-3676
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00942241 | Medicaid | NY | |
| 161350913 | Other | NY | FED TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039311-1 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1235253840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 DUNCAN ST",
"city": "WARSAW",
"state": "NY",
"postal_code": "145691017",
"telephone_number": "585-786-3676",
"fax_number": "585-786-3896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 DUNCAN ST",
"city": "WARSAW",
"state": "NY",
"postal_code": "145691017",
"telephone_number": "585-786-3676",
"fax_number": "585-786-3896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GBUREK",
"first_name": "MICHAEL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "039311-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00942241",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "161350913",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.