Edward Joseph Peloso, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

038246 Issued in NY

Practice address

3130 Grand Concourse
Apt #1M
Bronx, NY 10458-1213

Phone

(718) 364-7888

NPI assigned

Jan 3, 2007

Last updated

Apr 19, 2012By the provider in NPPES

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1184781551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "APT 1M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-364-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 GRAND CONCOURSE",
            "address_2": "APT #1M",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104581213",
            "telephone_number": "718-364-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOSO",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Pellegrino, PHARM D
• Sheeba Catherine Pellegrino, N.P.
• Cesar Emilio Pellerano Jr., LMHC
• Taisha Pelletier
• Teresa Jean Pelletier, MD
• Alexis Marie Pelowski, OD
• Crystalisa Peltz
• Academia Pelzer
• Celena Pelzer
• Aliza Pelzner, OTR/L

• General Practice Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; 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.