Individual provider Active NPI

Risha De Leon

  • General Practice Dentistry
  • Massapequa, NY
National Provider Identifier
1033306766
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9596 Issued in MA
Practice address
750 Hicksville Rd
Massapequa, NY 11758-1260
Phone
(516) 636-5641
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9596 MA Primary

Addresses

Primary practice location

750 Hicksville Rd
Massapequa, NY 11758-1260

Mailing address

750 Hicksville Rd
Massapequa, NY 11758-1260
Phone (516) 636-5641

Other names 1

  • Risha Molato Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161212001432 MA Practitioner - DentistPractitioner - Oral Surgery 5698055580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RMD Pearl Dental PLLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1033306766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HICKSVILLE RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581260",
            "telephone_number": "516-636-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HICKSVILLE RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581260",
            "telephone_number": "516-636-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "RISHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "9596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RISHA",
            "last_name": "MOLATO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.