Active NPI
Marcelle Matos Nascimento, D.D.S.
- General Practice Dentistry
- East Amherst, NY
National Provider Identifier
1275706426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DTP 497
- Practice address
- 8780 Millcreek Dr
East Amherst, NY 14051-2088 - Phone
- (352) 682-3431
- NPI assigned
- Apr 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DTP 497 | FL | Primary |
Addresses
Primary practice location
8780 Millcreek Dr
East Amherst, NY 14051-2088
Mailing address
8780 Millcreek Dr
East Amherst, NY 14051-2088
Phone (352) 273-5834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511001534 | FL | Order and Referring Only - Dentist | 8921397142 |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
615 Shipyard Blvd
Wilmington, NC 28412-6431
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DTP 497 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1275706426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8780 MILLCREEK DR",
"city": "EAST AMHERST",
"state": "NY",
"postal_code": "140512088",
"telephone_number": "352-273-5834",
"fax_number": "352-682-3431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8780 MILLCREEK DR",
"city": "EAST AMHERST",
"state": "NY",
"postal_code": "140512088",
"telephone_number": "352-682-3431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASCIMENTO",
"first_name": "MARCELLE",
"middle_name": "MATOS",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-09",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DTP 497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in East Amherst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.