Individual provider Active NPI

Peppino Bonelli, DDS

  • General Practice Dentistry
  • Bronx, NY
National Provider Identifier
1124112966
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
047708NY Issued in NY
Practice address
1475 Astor Avenue
DRS Darrigo and Bonelli DDS LLP
Bronx, NY 10469
Phone
(718) 653-2411
Fax
(718) 654-0035
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 047708NY NY Primary

Addresses

Primary practice location

1475 Astor Avenue
DRS Darrigo and Bonelli DDS LLP
Bronx, NY 10469

Mailing address

113 Woodcrest Avenue
White Plains, NY 10604
Phone (914) 831-0828

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
I20160113002517 NY Order and Referring Only - DentistPractitioner - Dentist 1456653013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047708NYNYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1124112966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WOODCREST AVENUE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10604",
            "telephone_number": "914-831-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 ASTOR AVENUE",
            "address_2": "DRS DARRIGO AND BONELLI DDS LLP",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10469",
            "telephone_number": "718-653-2411",
            "fax_number": "718-654-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONELLI",
        "first_name": "PEPPINO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "047708NY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.