Patrice Dianna Ferguson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

049050 Issued in NY

Practice address

770 Imperial Dr
Baldwin, NY 11510-4535

Phone

(516) 868-8781

Fax

(718) 949-2035

NPI assigned

Nov 1, 2007

Last updated

Nov 1, 2007By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193875200000",
    "number": "1174702609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 IMPERIAL DR",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104535",
            "telephone_number": "516-868-8781",
            "fax_number": "718-949-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 IMPERIAL DR",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115104535",
            "telephone_number": "516-868-8781",
            "fax_number": "718-949-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "PATRICE",
        "middle_name": "DIANNA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-01",
        "last_updated": "2007-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "049050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foremost Pharmacy LLC
• Joanna C Formont, LMHC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.