David Peto, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI02964900 Issued in NJ

Practice address

29 N Airmont Rd Ste 2
Suffern, NY 10901-4242

Phone

(845) 512-1219

NPI assigned

Apr 14, 2011

Last updated

Nov 29, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 7, 2017 through Feb 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1144510827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 N AIRMONT RD STE 2",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N AIRMONT RD STE 2",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014242",
            "telephone_number": "845-512-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETO",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02964900",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "063039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark F Peralta, MD
• Dalila Perez, RN
• Ayelet Perry
• Anne Petekiewicz, R.N.
• Peter T. Simonson, M.D., P.L.L.C.
• Michael Onofrio Petrella, M.D.
• Virginia Pettijohn, RN
• Thomas John Pflomm, R. PH.
• Aisha Philibert, RN
• Anju Philip

• Periodontics in Suffern, NY
• Providers in Suffern, NY by specialty
• Periodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.