George Robert Ditomassi III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16805 Issued in MA

Practice address

1795 Main Street
Suite 206
Springfield, MA 01103-1077

Phone

(413) 733-6576

Fax

(413) 731-8655

NPI assigned

Jul 16, 2006

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advance Dental, PC

  • Dentist
  • Springfield, MA
  • NPI 1568853612
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1275550220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 MAIN STREET",
            "address_2": "SUITE 206",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031077",
            "telephone_number": "413-733-6576",
            "fax_number": "413-731-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 MAIN STREET",
            "address_2": "SUITE 206",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011031077",
            "telephone_number": "413-733-6576",
            "fax_number": "413-731-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITOMASSI",
        "first_name": "GEORGE",
        "middle_name": "ROBERT",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "23130-875",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "16805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Dipersio, DO
• Luciana Gabriel Dirienzo
• Debra A. Disandro, M.D.
• McKenzee Disimile
• Lou Ann Distefano
• Sarah Joy Dixit, MD
• Brian Scott Dixon, D.C.
• Kedian Dixon
• Keith P Dixon
• Monique A Dixon

• General Practice Dentistry in Springfield, MA
• Providers in Springfield, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.