Active NPI
Kerisa Lynne Muffoletto, RDH
- Dental Hygienist
- Buffalo, NY
National Provider Identifier
1669026365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 027201-1
- Practice address
- 155 Lawn Ave
Buffalo, NY 14207-1816 - Phone
- (716) 875-2904
- NPI assigned
- Jul 31, 2019
- Last updated
- Jul 31, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 027201-1 | NY | Primary |
Addresses
Primary practice location
155 Lawn Ave
Buffalo, NY 14207-1816
Mailing address
5746 Ridge Rd
Lockport, NY 14094-9408
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
| License | State | Type | Specialty |
|---|---|---|---|
| 027201-1 | NY | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564531200000",
"number": "1669026365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5746 RIDGE RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140949408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 LAWN AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142071816",
"telephone_number": "716-875-2904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUFFOLETTO",
"first_name": "KERISA",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-31",
"last_updated": "2019-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NY",
"license": "027201-1",
"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 Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.