Individual provider Active NPI

Jenny Tan Sy-Munoz, DDS,MSD

  • Prosthodontics
  • Williamsville, NY
National Provider Identifier
1902016017
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
051911-1 Issued in NY
Practice address
531 Farber Lakes Dr
Williamsville, NY 14221-5773
Phone
(716) 633-7070
Fax
(716) 633-2595
NPI assigned
May 23, 2007
Sex
Female
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
Prosthodontics 1223P0700X 051911-1 NY Primary

Addresses

Primary practice location

531 Farber Lakes Dr
Williamsville, NY 14221-5773

Mailing address

531 Farber Lakes Dr
Williamsville, NY 14221-5773
Phone (716) 633-7070

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

LicenseStateTypeSpecialty
051911-1NYMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902016017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 FARBER LAKES DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215773",
            "telephone_number": "716-633-7070",
            "fax_number": "716-633-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 FARBER LAKES DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142215773",
            "telephone_number": "716-633-7070",
            "fax_number": "716-633-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY-MUNOZ",
        "first_name": "JENNY",
        "middle_name": "TAN",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "051911-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.