Jaclyn Marie Papa, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

057947 Issued in NY

Practice address

1016 Watervliet Shaker Rd
Albany, NY 12205

Phone

(518) 869-3114

Fax

(518) 869-6983

NPI assigned

Jun 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 11, 2016 through May 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1265846125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 WATERVLIET SHAKER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122052114",
            "telephone_number": "518-869-3114",
            "fax_number": "518-869-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 WATERVLIET SHAKER RD",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "12205",
            "telephone_number": "518-869-3114",
            "fax_number": "518-869-6983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPA",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Teresa Panzetta, M.D.
• Catarina M Paone, MS ANPC
• Christopher F. Paonessa, BOCO, C.PED
• Dominick F Paonessa, M.D.
• David Joseph Papa, DMD
• Louis M Papandrea, MD
• Aarti R Pappu, RPA-C
• Brienne Elizabeth Paradis Kaczenski, DO
• Anika V Paradkar
• Ria Paradkar

• General Practice Dentistry in Albany, NY
• Providers in Albany, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.