Peter Joseph De Lisi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

041680 Issued in NY

Practice address

12 Old Mamaroneck Rd
Suite 1H
White Plains, NY 10605-2010

Phone

(914) 686-5040

Fax

(914) 686-6181

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285852335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 OLD MAMARONECK RD",
            "address_2": "SUITE 1H",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052010",
            "telephone_number": "914-686-5040",
            "fax_number": "914-686-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 OLD MAMARONECK RD",
            "address_2": "SUITE 1H",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052010",
            "telephone_number": "914-686-5040",
            "fax_number": "914-686-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LISI",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Lee De Jager, MD
• Yacquery De Jesus, SPECIALIST
• Eileen O De la Cruz, DMD
• Yeimi De la Rosa
• Joanne De la Torre
• Alain C J De Lotbiniere, M.D.
• Paulo S De Oliveira, N.P.
• Maria De Pena-Nowak, M.D.
• Nelly F De Ridder, PHD, LCSW-R
• Kristen Marie Debisceglie, FNP

• General Practice Dentistry in White Plains, NY
• Providers in White Plains, NY by specialty
• General Practice Dentistry in New York

• 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.

Verify at the official NPI Registry.