Active NPI
Jeffrey B Lowenguth, D.D.S.
- General Practice Dentistry
- Victor, NY
National Provider Identifier
1356432322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 0453821
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 71131VD | Other | NY | EXCELLUS 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160427001452 | NY | Order and Referring Only - Dentist | 1951600840 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0453821 | NY | MD | General Practice Dentistry |
| 045382 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Victor, NY
- NPI 1538243548
-
- General Practice Dentistry
- Victor, NY
- NPI 1962759555
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.