Individual provider Active NPI

Kayla Marlene Pallotta, DMD

  • Dentist
  • Buffalo, NY
National Provider Identifier
1609511252
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
063225 Issued in NY
Practice address
1603 Hertel Ave
Buffalo, NY 14216-2903
Phone
(716) 838-1415
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 063225 NY Primary

Addresses

Primary practice location

1603 Hertel Ave
Buffalo, NY 14216-2903

Mailing address

1603 Hertel Ave
Buffalo, NY 14216-2903
Phone (716) 838-1415

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
063225NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1609511252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162903",
            "telephone_number": "716-838-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 HERTEL AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142162903",
            "telephone_number": "716-838-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLOTTA",
        "first_name": "KAYLA",
        "middle_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Apr 15, 2026; 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.