Individual provider Active NPI

Peter Joseph Pantano, D.D.S.

  • Dentist
  • Winchester, MA
National Provider Identifier
1134199268
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15556 Issued in MA
Practice address
955 Main St
Suite 201
Winchester, MA 01890-1961
Phone
(781) 729-5041
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15556 MA Primary

Addresses

Primary practice location

955 Main St
Suite 201
Winchester, MA 01890-1961

Mailing address

955 Main St
Suite 201
Winchester, MA 01890-4302
Phone (781) 729-5041

Other identifiers 1

IdentifierTypeStateIssuer
X05442OtherMABLUE CROSS OF MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150514002622 MA Order and Referring Only - DentistPractitioner - Dentist 2466772405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15556MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Hill Dental Associates PLLC PastSince Feb 25, 2024 Accepting new patients
Russell Hill Dental, PC Past Accepting new patients

Organizations & group practices 2

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1134199268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 201",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018904302",
            "telephone_number": "781-729-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 201",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-729-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTANO",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "15556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MA",
            "identifier": "X05442",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

Verify at the official NPI Registry.