Individual provider Active NPI

Anton Gregory Sohrweide, DDS

  • Dentist
  • Baldwinsville, NY
National Provider Identifier
1235260720
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30988 Issued in NY
Practice address
One Charlotte Street
Baldwinsville, NY 13027
Phone
(315) 638-0265
Fax
(315) 635-1788
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30988 NY Primary

Addresses

Primary practice location

One Charlotte Street
Baldwinsville, NY 13027

Mailing address

One Charlotte Street
Baldwinsville, NY 13027

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
I20160614000432 NY Order and Referring Only - DentistPractitioner - Dentist 5799076212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30988NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235260720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE CHARLOTTE STREET",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE CHARLOTTE STREET",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "13027",
            "telephone_number": "315-638-0265",
            "fax_number": "315-635-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHRWEIDE",
        "first_name": "ANTON",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "30988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinsville, NY

Sources for this page

Verify at the official NPI Registry.