Individual provider Active NPI

Joseph Anthony Dubanoski III, DDS

  • Dentist
  • Dover, NH
National Provider Identifier
1073625281
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1914 Issued in NH
Practice address
40 Chestnut St
Suite 2
Dover, NH 03820-3392
Phone
(603) 742-4735
Fax
(603) 742-9911
NPI assigned
Sep 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1914 NH Primary

Addresses

Primary practice location

40 Chestnut St
Suite 2
Dover, NH 03820-3392

Mailing address

40 Chestnut St
Suite 2
Dover, NH 03820-3392
Phone (603) 742-4735

Other identifiers 2

IdentifierTypeStateIssuer
0206020Y0NH01OtherNHBCBS
273740099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20150603002028 NH Order and Referring Only - DentistPractitioner - Dentist 6800117771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1914NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkway Dental Associates Dentist Past 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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544140800000",
    "number": "1073625281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CHESTNUT ST",
            "address_2": "SUITE 2",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203392",
            "telephone_number": "603-742-4735",
            "fax_number": "603-742-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CHESTNUT ST",
            "address_2": "SUITE 2",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203392",
            "telephone_number": "603-742-4735",
            "fax_number": "603-742-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBANOSKI",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2018-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "1914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0206020Y0NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273740099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.