Individual provider Active NPI

Salvatore Lanza, DDS

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1144316159
Registry record updated Mar 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
048854 Issued in NY
Practice address
4066 Amboy Rd
Staten Island, NY 10308-2409
Phone
(718) 972-2282
Fax
(718) 972-2281
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D102200600 NJ
General Practice Dentistry 1223G0001X 048854 NY Primary

Addresses

Primary practice location

4066 Amboy Rd
Staten Island, NY 10308-2409

Mailing address

4066 Amboy Rd
Staten Island, NY 10308-2409
Phone (718) 967-2282

Other practice location 1

2104 Victory Blvd
Staten Island, NY 10314
Phone (718) 698-2556

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22D102200600NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615680000000",
    "number": "1144316159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4066 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082409",
            "telephone_number": "718-967-2282",
            "fax_number": "718-967-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082409",
            "telephone_number": "718-972-2282",
            "fax_number": "718-972-2281"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2104 Victory Blvd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "10314",
            "country_code": "US",
            "telephone_number": "718-698-2556",
            "fax_number": "718-698-2547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANZA",
        "first_name": "SALVATORE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-14",
        "certification_date": "2021-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102200600",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.