John J Romano, D.D.S.

Individual provider Active NPI General Practice Dentistry · East Quogue, NY

NPI 1124184684 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124184684
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
50-036486 (NY)
Practice address
426 Montauk Hwy
East Quogue, NY 11942-3923
Phone
(631) 653-4479
Fax
(631) 653-4491
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
50-036486NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Fork Family Dentistry PC General Practice Past
since Jul 16, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50-036486 NY Yes

Addresses

Primary practice location

426 Montauk Hwy
East Quogue, NY 11942-3923

Mailing address

426 Montauk Hwy
East Quogue, NY 11942-3923
Phone (631) 283-6381

Other providers in East Quogue, NY

All providers in East Quogue, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.