Active NPI
Nino Carlo Deleon
- Dentist
- Richmond, VA
National Provider Identifier
1396110078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401415178
- Practice address
- 5500 Monument Ave Ste G
Richmond, VA 23226 - Phone
- (804) 282-4646
- NPI assigned
- Dec 7, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401415178 | VA | Primary |
Addresses
Primary practice location
5500 Monument Ave Ste G
Richmond, VA 23226
Mailing address
5500 Monument Ave Ste G
Richmond, VA 23226-1452
Phone (804) 282-4646
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200810001124 | VA | Practitioner - Dentist | 0345529293 | Practice locations: Richmond, VA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530835200000",
"number": "1396110078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5500 MONUMENT AVE STE G",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261452",
"telephone_number": "804-282-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 MONUMENT AVE STE G",
"city": "RICHMOND",
"state": "VA",
"postal_code": "23226",
"telephone_number": "804-282-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEON",
"first_name": "NINO CARLO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-07",
"last_updated": "2018-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401415178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.