Active NPI
Steven George Damelio, D.M.D.
- Dentist
- Penfield, NY
National Provider Identifier
1295836658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 42497-1
- Practice address
- 1794 Penfield Rd
Penfield, NY 14526-2124 - Phone
- (585) 381-2310
- Fax
- (585) 381-6709
- NPI assigned
- Sep 26, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 42497-1 | NY | Primary |
Addresses
Primary practice location
1794 Penfield Rd
Penfield, NY 14526-2124
Mailing address
91 Angels Path
Webster, NY 14580-2293
Phone (585) 787-1175
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160210002408 | NY | Order and Referring Only - Dentist | 0446554554 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42497-1 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295836658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 ANGELS PATH",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145802293",
"telephone_number": "585-787-1175",
"fax_number": "585-738-0067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1794 PENFIELD RD",
"city": "PENFIELD",
"state": "NY",
"postal_code": "145262124",
"telephone_number": "585-381-2310",
"fax_number": "585-381-6709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMELIO",
"first_name": "STEVEN",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "42497-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penfield, NY
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.