OrganizationActive
Brewerton Family Dentistry
NPI 1164553079 · Dentist · Brewerton, NY
Provider details
- NPI number
- 1164553079
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Organization subpart
- No
- Authorized official
- Imadeh Nosegbe, Owner(315) 676-2209
- License
- 051614 (NY)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5501 Bartel Rd
Brewerton, NY 13029-8701
Phone: (315) 676-2209
Fax: (315) 676-2247
Street-level locationGet directions
Mailing address
Po Box 830
Brewerton, NY 13029-0830
Registry dates
- Enumerated
- 2007-03-09
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.