Individual provider Active NPI

Jeffrey B Lowenguth, D.D.S.

  • General Practice Dentistry
  • Victor, NY
National Provider Identifier
1356432322
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0453821 Issued in NY
Practice address
277 W Main St
Victor, NY 14564-1123
Phone
(585) 924-3240
Fax
(585) 924-7768
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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 0453821 NY Primary

Addresses

Primary practice location

277 W Main St
Victor, NY 14564-1123

Mailing address

277 W Main St
Victor, NY 14564-1019
Phone (585) 924-3240

Other identifiers 1

IdentifierTypeStateIssuer
71131VDOtherNYEXCELLUS BLUE CROSS BLUE SHIELD ROCHESTER, NY

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
I20160427001452 NY Order and Referring Only - DentistPractitioner - Dentist 1951600840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0453821NYMDGeneral Practice Dentistry
045382NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor Family Dentistry General Practice Past Accepting new patients
Victor Family Dentistry, PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1356432322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 W MAIN ST",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641019",
            "telephone_number": "585-924-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 W MAIN ST",
            "city": "VICTOR",
            "state": "NY",
            "postal_code": "145641123",
            "telephone_number": "585-924-3240",
            "fax_number": "585-924-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWENGUTH",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0453821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BLUE CROSS BLUE SHIELD ROCHESTER, NY",
            "identifier": "71131VD",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victor, NY

Sources for this page

Verify at the official NPI Registry.