Jeremy Paul Bateman, DMD
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Brockport, NY
NPI 1972795870 · NPPES record last updated Apr 9, 2014
Key facts
- NPI
- 1972795870
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 056559 (NY)
- Practice address
- 175 East Ave
Brockport, NY 14420-1505 - Phone
- (919) 721-8034
- NPI assigned
- Aug 14, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056559 | NY | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bateman Orthodontics | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 056559 | NY | Yes |
Addresses
Primary practice location
175 East Ave
Brockport, NY 14420-1505
Mailing address
175 East Ave
Brockport, NY 14420
Phone (585) 637-4474
Other providers in Brockport, NY
- Kris Banister
- Diane J Barber
- Lindsey Irene Barber
- Shannon Bartlett
- Bateman Orthodontics
- Jennifer Bauch
- Ashley D Beckwith
- Nichole Elizabeth Bedford
- Darcy Louise Beeman
- Catherine M. Benjamin
All providers in Brockport, NY · Orthodontics and Dentofacial Orthopedics Dentistry in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.