Individual
JONATHAN M SIPIOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
275 THOMAS INDIAN SCHOOL DR, IRVING, NY 14081-9341
(716) 532-5582
(716) 242-6344
Mailing address
987 R C HOAG DR, SALAMANCA, NY 14779-1365
(716) 945-5894
(716) 242-6344
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
061170
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000558119001-002
BCBS
NY
05
—
06215214
—
NY
Enumeration date
06/07/2018
Last updated
04/21/2025
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