Virmaris L Perdomo, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

053986-1 Issued in NY

Practice address

1228 Wantagh Ave
# 102
Wantagh, NY 11793-2209

Phone

(516) 679-7978

NPI assigned

Aug 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Wantagh Dental Arts, PC

  • Dental Hygienist
  • Wantagh, NY
  • NPI 1114936929

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1053568709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 W 55TH ST",
            "address_2": "APT 1 I",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100194554",
            "telephone_number": "212-203-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 WANTAGH AVE",
            "address_2": "# 102",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117932209",
            "telephone_number": "516-679-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "VIRMARIS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "053986-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zareen Parvez, PA
• Jo Passeggio Barone
• Lori J Patti, LMT
• Maureen Kaippanchalil Paulose
• Gary Pelosi, LCSW
• Jennifer Perez-Lai, REGISTERED NURSE
• Beth Nicole Pergament, MSED
• Mark H Perlman, PH.D.
• Kristin Marie Perricelli, DPT
• Jeanette Perucca, M.S., CCC-SLP

• Periodontics in Wantagh, NY
• Providers in Wantagh, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.