Individual provider Active NPI

Karen Yesenia Milla Escobar, DDS

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1285021568
Registry record updated Sep 13, 2016
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
058613-1 Issued in NY
Practice address
1841 W Ridge Rd
Erie Canal Commons
Rochester, NY 14615-2504
Phone
(678) 650-1078
NPI assigned
Apr 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

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 058613-1 NY Primary

Addresses

Primary practice location

1841 W Ridge Rd
Erie Canal Commons
Rochester, NY 14615-2504

Mailing address

1796 Crittenden Rd
Apt #6
Rochester, NY 14623-1432
Phone (678) 650-1078

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
I20161108000991 NY Order and Referring Only - DentistPractitioner - Dentist 1951680396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058613-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1285021568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 CRITTENDEN RD",
            "address_2": "APT #6",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146231432",
            "telephone_number": "678-650-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 W RIDGE RD",
            "address_2": "ERIE CANAL COMMONS",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146152504",
            "telephone_number": "678-650-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLA ESCOBAR",
        "first_name": "KAREN",
        "middle_name": "YESENIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058613-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.