Charles D. Azzaretti, D.D.S.
Individual provider Active NPI Dental Anesthesiology · Mount Kisco, NY
NPI 1083808588 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1083808588
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Anesthesiology 1223D0004X
- License
- 036579 (NY)
- Practice address
- 439 E Main St
Mount Kisco, NY 10549-3404 - Phone
- (914) 666-3310
- Fax
- (914) 666-7924
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160609001771 | NY | Order and Referring Only - Other (Physician) |
1456641000 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036579 | NY | MD | Dentist Anesthesiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles D Azzaretti DDS and Ellen G Holliday DDS | Past | Accepting new patients |
Interoperability endpoints
- cazzaretti133768@nyumc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | 036579 | NY | Yes |
| General Practice Dentistry | 1223G0001X | 036579 | NY |
Addresses
Primary practice location
439 E Main St
Mount Kisco, NY 10549-3404
Mailing address
439 E Main St
Mount Kisco, NY 10549-3404
Phone (914) 666-3310
Other providers in Mount Kisco, NY
- Marybeth Augustine
- Joan A Austin
- Michael Andrew Avaricio
- Alphonse Aversa
- Rafael Z Axen
- Sateesh Babu
- Back to Health PT LLC
- Max Abraham Bader
- Barry Baer
- Kara Marie Bagni
All providers in Mount Kisco, NY · Dental Anesthesiology in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.