Individual provider Active NPI

Patrick J Paldino, DDS

  • General Practice Dentistry
  • Burlington, VT
National Provider Identifier
1205900495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
016-0001205 Issued in VT
Practice address
789 Pine St
Burlington, VT 05401-4933
Phone
(802) 862-1939
Fax
(802) 862-2608
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 016-0001205 VT Primary

Addresses

Primary practice location

789 Pine St
Burlington, VT 05401-4933

Mailing address

100 Saratoga Village Blvd
Suite 36a
Ballston Spa, NY 12020-3737
Phone (518) 899-9783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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

Enrollment IDStateProvider typePAC IDDetails
I20150612001036 VT Order and Referring Only - DentistPractitioner - Dentist 1850602178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016-0001205VTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205900495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE 36A",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9783",
            "fax_number": "518-899-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014933",
            "telephone_number": "802-862-1939",
            "fax_number": "802-862-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALDINO",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "016-0001205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.