Individual provider Active NPI

Robert A. Engl, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kenmore, NY
National Provider Identifier
1508893470
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
037732 Issued in NY
Practice address
3024 Delaware Ave
Kenmore, NY 14217-2305
Phone
(716) 874-9018
Fax
(716) 874-0272
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 037732 NY Primary

Addresses

Primary practice location

3024 Delaware Ave
Kenmore, NY 14217-2305

Mailing address

3024 Delaware Ave
P.O. Box 24
Kenmore, NY 14217-0024
Phone (716) 874-9018

Other identifiers 1

IdentifierTypeStateIssuer
01010737MedicaidNY

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1508893470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 DELAWARE AVE",
            "address_2": "P.O. BOX 24",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142170024",
            "telephone_number": "716-874-9018",
            "fax_number": "716-874-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172305",
            "telephone_number": "716-874-9018",
            "fax_number": "716-874-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGL",
        "first_name": "ROBERT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "037732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01010737",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.