Jennifer Christine Caroselli, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

053983-1 Issued in NY

Practice address

6536 Anthony Drive Suite a
Victor Dental Care
East Victor Place/ Victor, NY 14564

Phone

(585) 924-8940

NPI assigned

Aug 11, 2008

Last updated

Jan 5, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Christine Berner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kevin Bolger DDS PLLC

  dba Victor Dental Care

  • General Practice Dentistry
  • Victor, NY
  • NPI 1578235792
  NPD (past)
• Victor Dental Care PLLC

  • General Practice Dentistry
  • Victor, NY
  • NPI 1285271114
  NPD (past)

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1730335738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6536 ANTHONY DRIVE SUITE A",
            "address_2": "VICTOR DENTAL CARE",
            "city": "EAST VICTOR PLACE/ VICTOR",
            "state": "NY",
            "postal_code": "14564",
            "telephone_number": "585-924-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6536 ANTHONY DRIVE SUITE A",
            "address_2": "VICTOR DENTAL CARE",
            "city": "EAST VICTOR PLACE/ VICTOR",
            "state": "NY",
            "postal_code": "14564",
            "telephone_number": "585-924-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROSELLI",
        "first_name": "JENNIFER",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053983-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BERNER",
            "middle_name": "CHRISTINE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.