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BREWERTON FAMILY DENTISTRY
NPI 1164553079
Dentist in Brewerton, NY

Active since March 09, 2007
5501 BARTEL RD, BREWERTON, NY 13029(315) 676-2209(315) 676-2247 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Brewerton Family Dentistry NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREWERTON FAMILY DENTISTRY (NPI 1164553079) is a healthcare organization registered as a dentist in Brewerton, New York and active in the NPI registry since March 2007. The organization lists Imadeh R Nosegbe, Owner, as its authorized official.

NPPES Registry Identity

NPI1164553079
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameBREWERTON FAMILY DENTISTRY
Location Address5501 BARTEL RDBrewerton, NY 13029-8701
Mailing AddressPo Box 830Brewerton, NY 13029-0830 · (315) 676-2209 · Fax (315) 676-2247
Phone(315) 676-2209
Fax(315) 676-2247
Organization SubpartNo
Authorized OfficialImadeh R NosegbeOwner · (315) 676-2209
Enumeration DateMarch 9, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1164553079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in NY · 051614
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
5501 BARTEL RD, Brewerton, NY 13029
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Other Identifiers 1

Medicaid02570547NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIMOTHY RESTREPO I DDS
Dentist (Oral and Maxillofacial Surgery)
5501 BARTEL RD
BREWERTON, NY 13029
Onondaga County (716) 804-1591
TIMOTHY OKEEFE MD PC
Clinic/Center (Dental)
5501 BARTEL RD
BREWERTON, NY 13029
Onondaga County (315) 603-3795

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brewerton Family Dentistry's NPI number?

The NPI number for Brewerton Family Dentistry is 1164553079. It was assigned to this organization in the NPPES registry on March 9, 2007.

Where is Brewerton Family Dentistry located?

Brewerton Family Dentistry is located at 5501 Bartel Rd, Brewerton, NY 13029. The listed phone number is (315) 676-2209.

What is Brewerton Family Dentistry's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Brewerton Family Dentistry was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.