Individual provider Active NPI

Madelyn Kaye Sadibasic, DDS

  • Dentist
  • Tonawanda, NY
National Provider Identifier
1699290064
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
059336 Issued in NY
Practice address
2929 Sheridan Dr
Tonawanda, NY 14150-9440
Phone
(716) 831-8844
NPI assigned
Aug 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 059336 NY Primary

Addresses

Primary practice location

2929 Sheridan Dr
Tonawanda, NY 14150-9440

Mailing address

165 Peppertree Dr Apt 3
Amherst, NY 14228-2928

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
059336NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1699290064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 PEPPERTREE DR APT 3",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142282928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 SHERIDAN DR",
            "city": "TONAWANDA",
            "state": "NY",
            "postal_code": "141509440",
            "telephone_number": "716-831-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADIBASIC",
        "first_name": "MADELYN",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "059336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.