Individual provider Active NPI

Gina Lodolini, DDS

  • Pediatric Dentistry
  • Mt Kisco, NY
National Provider Identifier
1104030147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
043486 Issued in NY
Practice address
241-Lexington Ave
Mt Kisco, NY 10549
Phone
(914) 242-2000
Fax
(914) 242-6254
NPI assigned
May 9, 2007
Sex
Female
Sole proprietor
Yes

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
Pediatric Dentistry 1223P0221X 043486 NY Primary

Addresses

Primary practice location

241-Lexington Ave
Mt Kisco, NY 10549

Mailing address

241-Lexington Ave
Mt Kisco, NY 10549
Phone (914) 242-2000

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
I20161117000001 NY Order and Referring Only - DentistPractitioner - Dentist 2466731351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
043486NYMDPhysical Therapy Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104030147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241-LEXINGTON AVE",
            "city": "MT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-242-2000",
            "fax_number": "914-242-6254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241-LEXINGTON AVE",
            "city": "MT KISCO",
            "state": "NY",
            "postal_code": "10549",
            "telephone_number": "914-242-2000",
            "fax_number": "914-242-6254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODOLINI",
        "first_name": "GINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "043486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Kisco, NY

Sources for this page

Verify at the official NPI Registry.