Individual provider Active NPI

Frank Patrick Di Blasi, DDS

  • Dentist
  • Massapequa, NY
National Provider Identifier
1396856282
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
030521 Issued in NY
Practice address
690 Broadway Massapequa Ny 11758 2367
Massapequa, NY 11758-2367
Phone
(516) 795-5769
Fax
(516) 795-8872
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 030521 NY Primary

Addresses

Primary practice location

690 Broadway Massapequa Ny 11758 2367
Massapequa, NY 11758-2367

Mailing address

690 Broadway
Massapequa, NY 11758-2367
Phone (516) 795-5769

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

LicenseStateTypeSpecialty
030521NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396856282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 BROADWAY",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582367",
            "telephone_number": "516-795-5769",
            "fax_number": "516-795-8872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BROADWAY MASSAPEQUA NY 11758 2367",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582367",
            "telephone_number": "516-795-5769",
            "fax_number": "516-795-8872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI BLASI",
        "first_name": "FRANK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "030521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.