Individual provider Active NPI

Dominick John Anziano II

  • Behavior Analyst
  • Stone Mountain, GA
National Provider Identifier
1013877844
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
RBT-25-431026 Issued in GA
Practice address
740 Stoneside CT
Stone Mountain, GA 30083-6002
Phone
(404) 668-7324
NPI assigned
Nov 14, 2025
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X RBT-25-431026 GA Primary

Addresses

Primary practice location

740 Stoneside CT
Stone Mountain, GA 30083-6002

Mailing address

740 Stoneside CT
Stone Mountain, GA 30083-6002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-25-431026GAMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1013877844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 STONESIDE CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300836002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 STONESIDE CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300836002",
            "telephone_number": "404-668-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANZIANO",
        "first_name": "DOMINICK",
        "middle_name": "JOHN",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "RBT-25-431026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.