Michael Domenick Damico

Primary specialty

DentistTaxonomy code 122300000X

License

043141 Issued in NY

Practice address

222 Middle Country Rd
Suite 316
Smithtown, NY 11787-2871

Phone

(631) 724-4747

Fax

(631) 780-6528

NPI assigned

Feb 10, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134492945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST",
            "address_2": "STE 316",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872814",
            "telephone_number": "631-724-4747",
            "fax_number": "631-780-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MIDDLE COUNTRY RD",
            "address_2": "SUITE 316",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117872871",
            "telephone_number": "631-724-4747",
            "fax_number": "631-780-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "MICHAEL",
        "middle_name": "DOMENICK",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-10",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "043141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noshir A Dacosta, MD
• Danielle Dacres
• David Jonathan Dagate, M.D.
• Julia Roberta Daleo, PA-C
• Christina Marie Dalrymple, NP-C
• Jesse Damm
• Kaitlyn Dangelmaier
• Daniel L Mayer MD PC
• Danzi & Hajduk-Bennett Pediatrics PLLC
• Stephania Daneica Darbonne

• Dentist in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.