Individual provider Active NPI

Michael Fricchione, D.D.S.

  • General Practice Dentistry
  • Astoria, NY
National Provider Identifier
1396826798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
037559 Issued in NY
Practice address
3619 30TH Ave
Astoria, NY 11103-4375
Phone
(718) 728-7890
Fax
(718) 728-7845
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 037559 NY Primary

Addresses

Primary practice location

3619 30TH Ave
Astoria, NY 11103-4375

Mailing address

36-19 30TH Avenue
Astoria, NY 11103
Phone (718) 728-7890

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151202002347 NY Order and Referring Only - DentistPractitioner - Dentist 1557661261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
037559NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396826798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36-19 30TH AVENUE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "11103",
            "telephone_number": "718-728-7890",
            "fax_number": "718-728-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111034375",
            "telephone_number": "718-728-7890",
            "fax_number": "718-728-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICCHIONE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "037559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.