Anthony George Pavone, D.D.S. M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0491391 Issued in NY

Practice address

2 Medical Park Dr Ste 6
West Nyack, NY 10994-1966

Phone

(845) 675-8008

Fax

(845) 675-8010

NPI assigned

Oct 5, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: apavone51497@northwell.direct-ci.com

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1366538142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK DR STE 6",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109941966",
            "telephone_number": "845-675-8008",
            "fax_number": "845-675-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PARK DR STE 6",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109941966",
            "telephone_number": "845-675-8008",
            "fax_number": "845-675-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVONE",
        "first_name": "ANTHONY",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S. M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "0491391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2366611",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "0491391",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Palmer, LCSW
• Ghousia Jabeen Pasha, M.D.
• Rachana Patel
• Seema G Patel, O.D.
• Sandra Elizabeth Paucar, LCSW
• Pediatric Cardiology of Rockland, PLLC
• Xiangmin Peng, MD
• Pamela Picker, CF-SLP, TSSLD
• Consolacion Tanedo Pimentel, MD
• Charis Olympia Pinkston, R.N.

• Oral and Maxillofacial Surgery (Dentist) in West Nyack, NY
• Providers in West Nyack, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.