Anthony Dicostanzo DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007851A Issued in IN

Legal business name

ANTHONY DICOSTANZO DDS PC

Practice address

1123 Joliet St
Dyer, IN 46311-1926

Phone

(219) 865-3303

Fax

(219) 865-3244

NPI assigned

Jun 17, 2015

Organization subpart

No

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

Authorized official

Name

Marti Benne

Title

Office Mananger

Phone

(219) 865-3303

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Smiles By Doctor D Doing business as

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1306227129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111926",
            "telephone_number": "219-865-3303",
            "fax_number": "219-865-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 JOLIET ST",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111926",
            "telephone_number": "219-865-3303",
            "fax_number": "219-865-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY DICOSTANZO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "BENNE",
        "authorized_official_first_name": "MARTI",
        "authorized_official_title_or_position": "OFFICE MANANGER",
        "authorized_official_telephone_number": "219-865-3303"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007851A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100168120A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles By Doctor D",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• American Partners LP
• Allison Leigh Amptmeyer, PT, DPT
• Kala Anders, LCPC
• John D Andress, MD
• Andrew F. Mansueto, O.D.
• Anthony M Grimaldi, DO PC
• Cheryl L Anthony Worix, MD
• Candee Argamasilla-Walsh
• Grace Zhou Armstrong
• David Arnold, DDS

• All providers in Dyer, IN
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.