Individual provider Active NPI

Anthony Citriniti, DDS

  • Dentist
  • Farmingdale, NY
National Provider Identifier
1053454322
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
034105 Issued in NY
Practice address
475 Main Street
Suite 1E
Farmingdale, NY 11735
Phone
(516) 249-0898
Fax
(516) 249-0905
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 034105 NY Primary

Addresses

Primary practice location

475 Main Street
Suite 1E
Farmingdale, NY 11735

Mailing address

475 Main Street
Suite 1E
Farmingdale, NY 11735
Phone (516) 249-0898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20160525003126 NY Order and Referring Only - DentistPractitioner - Dentist 1951691351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
034105NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053454322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 MAIN STREET",
            "address_2": "SUITE 1E",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "11735",
            "telephone_number": "516-249-0898",
            "fax_number": "516-249-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 MAIN STREET",
            "address_2": "SUITE 1E",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "11735",
            "telephone_number": "516-249-0898",
            "fax_number": "516-249-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CITRINITI",
        "first_name": "ANTHONY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "034105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

Verify at the official NPI Registry.