Suburban Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0321781 Issued in NY

Legal business name

SUBURBAN ORTHODONTICS

Practice address

2005 Niagara Falls Blvd
Amherst, NY 14228-3520

Phone

(716) 568-8044

Fax

(716) 649-1516

NPI assigned

Apr 23, 2008

Last updated

Nov 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Bavisotto, DDSNPI 1619984515

Title

Orthodontist

Phone

(716) 649-5254

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert S Bavisotto, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Amherst, NY
  • NPI 1619984515
  NPD (past) Authorized official

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1366617250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 NIAGARA FALLS BLVD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283520",
            "telephone_number": "716-568-8044",
            "fax_number": "716-649-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 NIAGARA FALLS BLVD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283520",
            "telephone_number": "716-568-8044",
            "fax_number": "716-649-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "BAVISOTTO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "716-649-5254",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "0321781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01369268",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Lynn Studer, P.T.
• Dominic Pietro Stutz, PA
• Gary Styn
• Winnie S. Su, MD
• Suburban Family Dental
• Suburban Oxygen Supply Inc.
• Suburban Psychiatric Associates, LLP
• Nancy Ann Suda, LMHC
• Oren Sudai, DMD
• Emily Sullivan

• Orthodontics and Dentofacial Orthopedics Dentistry in Amherst, NY
• Providers in Amherst, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.