Organization Active NPI

Santa Locascio DDS PC

  • Dentist
  • Ridgewood, NY
National Provider Identifier
1326018300
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SANTA LOCASCIO DDS PC
Practice address
7016 Fresh Pond Rd
Ridgewood, NY 11385-5902
Phone
(718) 628-6588
Fax
(718) 628-9579
NPI assigned
Jan 24, 2006
Last updated
Apr 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Authorized official

Name
Dr. Santa Locascio, DDSNPI 1801112495
Title
Authorized Official
Phone
(718) 628-6588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

7016 Fresh Pond Rd
Ridgewood, NY 11385-5902

Mailing address

70-16 Fresh Pond Rd
Ridgewood, NY 11414
Phone (718) 628-6588

Other identifiers 1

IdentifierTypeStateIssuer
01197731MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150623000121 NY Part B Supplier - Clinic/Group Practice 0547571242 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgewood, NY

National Provider Directory

National Provider Directory

Locations

7016 Fresh Pond Rd
Ridgewood, NY 11385
Phone (718) 628-6588

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1326018300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70-16 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "11414",
            "telephone_number": "718-628-6588",
            "fax_number": "718-628-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7016 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855902",
            "telephone_number": "718-628-6588",
            "fax_number": "718-628-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA LOCASCIO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "LOCASCIO",
        "authorized_official_first_name": "SANTA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "718-628-6588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01197731",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.