Individual provider Active NPI

Clifford L Anzilotti Jr., D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wilmington, DE
National Provider Identifier
1144316209
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1990015088 Issued in DE
Practice address
2101 Foulk Rd
Wilmington, DE 19810-4710
Phone
(302) 475-2050
NPI assigned
Oct 5, 2006
Last updated
Apr 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1990015088 DE Primary

Addresses

Primary practice location

2101 Foulk Rd
Wilmington, DE 19810-4710

Mailing address

2101 Foulk Rd
Wilmington, DE 19810-4710

Other practice location 1

112 Saint Annes Church Rd
Middletown, DE 19709-1495
Phone (302) 378-2778

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
1990015088DEMDOrthodontics and Dentofacial Orthopedic Dentist

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": "1650499200000",
    "number": "1144316209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 FOULK RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FOULK RD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104710",
            "telephone_number": "302-475-2050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Saint Annes Church Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197091495",
            "country_code": "US",
            "telephone_number": "302-378-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANZILOTTI",
        "first_name": "CLIFFORD",
        "middle_name": "L",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "DE",
            "license": "1990015088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.