Active NPI
Andrew J Palermo
- Orthodontics and Dentofacial Orthopedics Dentistry
- Fall River, MA
National Provider Identifier
1356902068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN1858427
- Practice address
- 933 Pleasant St
Fall River, MA 02723-1000 - Phone
- (774) 301-8428
- NPI assigned
- Jun 24, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 060378 | NY | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN1858427 | MA | Primary |
Addresses
Primary practice location
933 Pleasant St
Fall River, MA 02723-1000
Mailing address
933 Pleasant St Ste 102-103
Fall River, MA 02723-1000
Phone (508) 673-3044
Other practice location 1
728 N Main St
New Square, NY 10977-8916
Phone (845) 354-9300
Other practice location 2
137 Hathaway Rd
New Bedford, MA 02746-1304
Phone (774) 425-0613
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060378 | Other | NY | APPLICATION PENDING |
| 060378 | Other | NY | NEW PROVIDER APPLICATION BEING SUBMITTED |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060378 | NY | MD | Dentist |
| DN1858427 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1356902068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 PLEASANT ST STE 102-103",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027231000",
"telephone_number": "508-673-3044",
"fax_number": "508-673-4396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 PLEASANT ST",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027231000",
"telephone_number": "774-301-8428"
}
],
"practiceLocations": [
{
"address_1": "728 N Main St",
"address_purpose": "LOCATION",
"city": "New Square",
"state": "NY",
"postal_code": "109778916",
"country_code": "US",
"telephone_number": "845-354-9300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "137 Hathaway Rd",
"address_purpose": "LOCATION",
"city": "New Bedford",
"state": "MA",
"postal_code": "027461304",
"country_code": "US",
"telephone_number": "774-425-0613",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PALERMO",
"first_name": "ANDREW",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-24",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "060378",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MA",
"license": "DN1858427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APPLICATION PENDING",
"identifier": "060378",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW PROVIDER APPLICATION BEING SUBMITTED",
"identifier": "060378",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fall River, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.