Individual provider Active NPI

Grigorios Lavrentiadis

  • Prosthodontics
  • Buffalo, NY
National Provider Identifier
1457072126
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
000141 Issued in NY
Practice address
215 Squire Hall
Buffalo, NY 14214-8006
Phone
(716) 645-8131
NPI assigned
Sep 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 000141 NY Primary

Addresses

Primary practice location

215 Squire Hall
Buffalo, NY 14214-8006

Mailing address

215 Squire Hall
Buffalo, NY 14214-8006
Phone (716) 645-8131

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://dental.buffalo.edu/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000141NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1457072126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142148006",
            "telephone_number": "716-645-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 SQUIRE HALL",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142148006",
            "telephone_number": "716-645-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVRENTIADIS",
        "first_name": "GRIGORIOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "000141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://dental.buffalo.edu/",
            "affiliation": "N",
            "address_1": "215 Squire Hall",
            "city": "Buffalo",
            "state": "NY",
            "country_code": "US",
            "postal_code": "142148006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.