DR. SIDNEY LAWRENCE BOURGEOIS JR. D.D.S.
NPI 1629071154
Dentist - Oral and Maxillofacial Surgery in Syracuse, NY

Q: What is Sidney Bourgeois's NPI number?

The NPI number for Sidney Bourgeois is 1629071154. It was assigned to this individual provider in the NPPES registry on May 30, 2005.

Q: What is Sidney Bourgeois's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Sidney Bourgeois was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 30, 2005PECOS Enrolled

800 IRVING AVENUE (160), SYRACUSE, NY 13210(315) 425-2468(315) 425-4415 Get Directions Write a Review

NPPES record last updated: July 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 28, 2021, Jul 13, 2019 (2 updates tracked since 2019).

On this page

About Dr. Sidney Lawrence Bourgeois Jr. D.d.s. NPPES

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

DR. SIDNEY LAWRENCE BOURGEOIS JR. D.D.S. (NPI 1629071154) is an individual oral and maxillofacial surgery provider in Syracuse, New York, licensed in New York (056936) and active in the NPI registry since May 2005. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1629071154

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. SIDNEY LAWRENCE BOURGEOIS JR.Credential: D.D.S.

Location Address800 IRVING AVENUE (160)Syracuse, NY 13210

Mailing Address800 Irving Avenue (160)Syracuse, NY 13210 · (315) 425-2468 · Fax (315) 425-4415

Phone(315) 425-2468

Fax(315) 425-4415

Sole ProprietorNo

Enumeration DateMay 30, 2005

Last NPPES UpdateJuly 28, 20212 updates tracked since enumeration

NPPES CertifiedJuly 3, 2021

✔ NPI 1629071154 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in NY · 056936✔ Licensed in TX · 22617

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedOral & Maxillofacial SurgeryTaxonomy 204E00000X · License 22617 (TX), 056936 (NY)

800 IRVING AVENUE (160), Syracuse, NY 13210

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Secondary Practice Locations 2

Location 1Syracuse Oral and Maxillofacial Surgery, 516 East Genesee StreetFayetteville, NY 13066 · Phone (315) 637-4476 · Fax (315) 637-1261

Location 2Syracuse Oral and Maxillofacial Surgery, 578 Seneca StreetOneida, NY 13421 · Phone (315) 363-8233 · Fax (315) 363-5043

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sidney Lawrence Bourgeois Jr. D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 13210 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.57 typical visit price

range $17.54 – $136.14

Typical copayment $17.14 (range $4.38 – $34.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Sidney Bourgeois's NPI number?

The NPI number for Sidney Bourgeois is 1629071154. It was assigned to this individual provider in the NPPES registry on May 30, 2005.

Where is Sidney Bourgeois located?

Sidney Bourgeois practices at 800 Irving Avenue (160), Syracuse, NY 13210. The listed phone number is (315) 425-2468.

What is Sidney Bourgeois's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Sidney Bourgeois enrolled in Medicare?

Yes. Sidney Bourgeois is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Sidney Bourgeois was last updated on July 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.