Jason J Setlock, DDS
Individual provider Active NPI Endodontics · Buffalo, NY
NPI 1699808709 · NPPES record last updated Apr 5, 2011
Key facts
- NPI
- 1699808709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- D07771 (AZ)
- Practice address
- 95 Meadow Rd
Buffalo, NY 14216-3613 - Phone
- (480) 297-6232
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 19, 2025 through Feb 19, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D07771 | AZ | MD | Endodontist |
| 050073 | NY | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apex Endodontics, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 050073 | NY | |
| Endodontics | 1223E0200X | D07771 | AZ | Yes |
Addresses
Primary practice location
95 Meadow Rd
Buffalo, NY 14216-3613
Mailing address
95 Meadow Rd
Buffalo, NY 14216-3613
Phone (480) 297-6232
Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.