Bruce Harvey Seidberg, DDS, MSCD, JD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

024191 Issued in NY

Practice address

5112 W Taft Road
Suite 'R'
Liverpool, NY 13088-4868

Phone

(315) 453-3636

Fax

(315) 466-3636

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 12, 2015 through Jan 12, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Juris Doctor

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Endodontics PC

  • Endodontics
  • Liverpool, NY
  • NPI 1396881389
  NPD (past) Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841356649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 W TAFT RD",
            "address_2": "SUITE 'R'",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884868",
            "telephone_number": "315-453-3636",
            "fax_number": "315-466-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 W TAFT ROAD",
            "address_2": "SUITE 'R'",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884868",
            "telephone_number": "315-453-3636",
            "fax_number": "315-466-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDBERG",
        "first_name": "BRUCE",
        "middle_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "DDS, MSCD, JD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "024191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Scimone, R.N.
• Joseph Anthony Scordo
• Michele Bravo Scott
• Amy D Scullion, FNP
• Patricia Rose Sehlmeyer, NP
• Edina Selimovic, RN
• Young Il Seo, MD
• Marilynn Sergott, FNP-C
• Rajeev K. Seth, MD
• Judith A Setla, M.D.

• Endodontics in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.