Individual provider Active NPI

Leonard M Attisano, DMD

  • General Practice Dentistry
  • Manchester, NH
National Provider Identifier
1285648220
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2206 Issued in NH
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

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
520702OtherNHUNITED CONCORDIA IDENT.
XRO024OtherMABCBS MASS
30003837MedicaidNH

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717002112 NH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9830402908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16888MAMDGeneral 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

Verify at the official NPI Registry.