Adam C Desanctis, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

16002122 Issued in VT

Practice address

27 N Willard St
Burlington, VT 05401-3312

Phone

(802) 862-8625

NPI assigned

Dec 30, 2006

Last updated

Oct 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 8, 2022 through Nov 8, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Willard Street Family Dental

  • Dentist
  • Burlington, VT
  • NPI 1427226380
  NPD (past) Authorized official
• Barclay & Fersing Inc

  • Dentist
  • Burlington, VT
  • NPI 1447248919
  NPD (past)

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

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1356407407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 N WILLARD ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013312",
            "telephone_number": "802-862-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 N WILLARD ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013312",
            "telephone_number": "802-862-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANCTIS",
        "first_name": "ADAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-30",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "16002122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Hendrik Denkmann, M.D.
• Lisa Dennis
• Benjamin Joseph Depo, MD
• Pamela Derickson, MD
• Loren Michele Deron
• Claude Deschamps, M.D.
• Chassidy Lynn Deslauriers, R.D
• Nancy J Desrault, MSW LICSW
• April Constance Destefano, MD
• Kristen Destigter, MD

• Dentist in Burlington, VT
• Providers in Burlington, VT by specialty
• Dentist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.