Active NPI
Leonard M Attisano, DMD
- General Practice Dentistry
- Manchester, NH
National Provider Identifier
1285648220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2206
- Practice address
- 700 Lake Ave
Manchester, NH 03103-2734 - Phone
- (603) 668-0227
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2206 | NH | Primary |
| General Practice Dentistry | 1223G0001X | 16888 | MA |
Addresses
Primary practice location
700 Lake Ave
Manchester, NH 03103-2734
Mailing address
167 Byam Rd
New Boston, NH 03070-3730
Phone (603) 487-3307
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 520702 | Other | NH | UNITED CONCORDIA IDENT. |
| XRO024 | Other | MA | BCBS MASS |
| 30003837 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150717002112 | NH | Order and Referring Only - Oral Surgery | 9830402908 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16888 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285648220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "167 BYAM RD",
"city": "NEW BOSTON",
"state": "NH",
"postal_code": "030703730",
"telephone_number": "603-487-3307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 LAKE AVE",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031032734",
"telephone_number": "603-668-0227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATTISANO",
"first_name": "LEONARD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NH",
"license": "2206",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "16888",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA IDENT.",
"identifier": "520702",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MASS",
"identifier": "XRO024",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30003837",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.