Individual provider Active NPI

Bryan D Pieroni, DDS

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1255509337
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
044780-1 Issued in NY
Practice address
763 Clove Rd
Staten Island, NY 10310
Phone
(718) 442-5319
NPI assigned
Feb 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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 044780-1 NY Primary

Addresses

Primary practice location

763 Clove Rd
Staten Island, NY 10310

Mailing address

763 Clove Rd
Staten Island, NY 10310-2738
Phone (718) 442-5319

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191024001369 NY Order and Referring Only - DentistPractitioner - Dentist 1850623885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
044780-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1255509337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102738",
            "telephone_number": "718-442-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10310",
            "telephone_number": "718-442-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERONI",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "044780-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.