Individual provider Active NPI

Martin Anthony Sorbero, DDS

  • General Practice Dentistry
  • Canajoharie, NY
National Provider Identifier
1699844779
Registry record updated Jul 8, 2007
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Nov 19, 2020.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
037373 Issued in NY
Practice address
66 Montgomery Street
Canajoharie, NY 13317
Phone
(518) 673-5410
Fax
(518) 673-8285
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 037373 NY Primary

Addresses

Primary practice location

66 Montgomery Street
Canajoharie, NY 13317

Mailing address

66 Montgomery Street
Canajoharie, NY 13317
Phone (518) 673-5410

Other identifiers 1

IdentifierTypeStateIssuer
00758356MedicaidNY

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
037373NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699844779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 MONTGOMERY STREET",
            "city": "CANAJOHARIE",
            "state": "NY",
            "postal_code": "13317",
            "telephone_number": "518-673-5410",
            "fax_number": "518-673-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 MONTGOMERY STREET",
            "city": "CANAJOHARIE",
            "state": "NY",
            "postal_code": "13317",
            "telephone_number": "518-673-5410",
            "fax_number": "518-673-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORBERO",
        "first_name": "MARTIN",
        "middle_name": "ANTHONY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "037373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00758356",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canajoharie, NY

Sources for this page

Verify at the official NPI Registry.