Active NPI
Martin Gorkiewicz
- Dentist
- Buffalo, NY
National Provider Identifier
1720471063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 058512-1
- Practice address
- 956 Kenmore Ave
Buffalo, NY 14216-1450 - Phone
- (716) 874-7112
- Fax
- (716) 874-7113
- NPI assigned
- Mar 11, 2015
- Last updated
- Feb 7, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 058512-1 | NY | Primary |
Addresses
Primary practice location
956 Kenmore Ave
Buffalo, NY 14216-1450
Mailing address
956 Kenmore Ave
Buffalo, NY 14216-1450
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 |
|---|---|---|---|
| 058512-1 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LC Dentistry PC | Past | Accepting new patients | |
| Kenmore Qualitycare Dentistry, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Buffalo, NY
- NPI 1902077928
-
dba Dr. Bob's Dental of Cheektowaga
- General Practice Dentistry
- Cheektowaga, NY
- NPI 1568811164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1720471063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "956 KENMORE AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142161450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "956 KENMORE AVE",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142161450",
"telephone_number": "716-874-7112",
"fax_number": "716-874-7113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORKIEWICZ",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-11",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "058512-1",
"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 Feb 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.