Provider Demographics
NPI:1356581821
Name:CHARLES E SINATRA DDS
Entity type:Organization
Organization Name:CHARLES E SINATRA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:SINATRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-487-1050
Mailing Address - Street 1:502 FOOTE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-8205
Mailing Address - Country:US
Mailing Address - Phone:716-487-1050
Mailing Address - Fax:716-488-0652
Practice Address - Street 1:502 FOOTE AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-8205
Practice Address - Country:US
Practice Address - Phone:716-487-1050
Practice Address - Fax:716-488-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00598765Medicaid