Clover Leaf Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CLOVER LEAF DENTAL PLLC

Doing business as

Clover Leaf Family Dentistry

Practice address

59 Elizabeth Dr
Lockport, NY 14094-5226

Phone

(716) 433-8332

NPI assigned

Mar 14, 2023

Last updated

Mar 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacqueline Szczupakowski, DDSNPI 1720484165

Title

Owner

Phone

(716) 913-4274

Specialties & licenses 1

Addresses

Other names 1

• Clover Leaf Family Dentistry Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Szczupakowski

  • Dentist
  • Amherst, NY
  • NPI 1720484165
  NPD Authorized official
• Erin Gilmore, D.M.D.

  • Dentist
  • Lockport, NY
  • NPI 1891178422
  NPD
• Mark E Mahaney, DDS

  • General Practice Dentistry
  • Lockport, NY
  • NPI 1952524423
  NPD (past)

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1871294116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-433-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 ELIZABETH DR",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945226",
            "telephone_number": "716-433-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER LEAF DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A",
        "authorized_official_last_name": "SZCZUPAKOWSKI",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "716-913-4274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clover Leaf Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaclyn Clare, M.S
• Sierra Clark, LMHC-P
• Valerie Clark, EMT
• Brianna Clemons
• Diane Lynn Clogston, COTA
• Taija-Rae Cochran, MSW
• Adrienne D Cohan, LCSW
• Ann Catherine Coia, RN, ANP
• Luann Coleman, RN
• Maryellen D Colling, CCC/SLP

• Dental Clinic/Center in Lockport, NY
• Providers in Lockport, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.