Individual provider Active NPI

Steven J Hietanen, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hamburg, NY
National Provider Identifier
1265545529
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
041550 Issued in NY
Practice address
4031 Legion Dr
Hamburg, NY 14075-4507
Phone
(716) 648-1461
Fax
(716) 312-0036
NPI assigned
Aug 17, 2006
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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 041550 NY Primary

Addresses

Primary practice location

4031 Legion Dr
Hamburg, NY 14075-4507

Mailing address

5360 Fairgrounds Rd
Hamburg, NY 14075-3007
Phone (716) 646-9185

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
I20210930002335 NY Practitioner - Dentist 5698172856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health Current Accepting new patients
Kaleida Health CurrentSince Sep 1, 2021 Accepting new patients
Kaleida Health CurrentSince Sep 1, 2021 Accepting new patients
Col-Dent Lab, Inc. Past Accepting new patients
Volumetric Craniofacial Imaging Centers Past Accepting new patients

Locations

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

900 Hertel Ave
Buffalo, NY 14216
Phone (716) 871-1571

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265545529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 FAIRGROUNDS RD",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140753007",
            "telephone_number": "716-646-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4031 LEGION DR",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754507",
            "telephone_number": "716-648-1461",
            "fax_number": "716-312-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIETANEN",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "041550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.