NPIMap

Individual provider Active NPI

Antonio L Del Valle, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • New York, NY
National Provider Identifier
1477624989
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
048825-1 Issued in NY
Practice address
45 W 54TH St
#1E
New York, NY 10019-5404
Phone
(212) 245-5801
Fax
(212) 977-9648
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 20681 NJ
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 251014 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 048825-1 NY Primary

Addresses

Primary practice location

45 W 54TH St
#1E
New York, NY 10019-5404

Mailing address

135 E 50TH St
#5E
New York, NY 10022-7504
Phone (917) 450-6531

Other identifiers 1

IdentifierTypeStateIssuer
02083594MedicaidNY

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20681NJMDOral and Maxillofacial Surgery (Dentist)
048825-1NYMDOral and Maxillofacial Surgery (Dentist)
048825NYMDPharmacist
251014NYMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Hoboken Oral Surgery Group Oral and Maxillofacial Surgery PastSince Jan 1, 1990 Accepting new patients
Downtown Bronx Medical Associates PC Past Accepting new patients
Hoboken Oral Surgery Group Oral and Maxillofacial Surgery PastSince Jan 1, 1990 Accepting new patients
A.L. del Valle, P.C. Past Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Lincon Medical and Mental Center Past Accepting new patients
Nyc Oral Surgery Associates Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1477624989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E 50TH ST",
            "address_2": "#5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100227504",
            "telephone_number": "917-450-6531",
            "fax_number": "212-213-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W 54TH ST",
            "address_2": "#1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195404",
            "telephone_number": "212-245-5801",
            "fax_number": "212-977-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL VALLE",
        "first_name": "ANTONIO",
        "middle_name": "L",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "20681",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NY",
            "license": "251014",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "048825-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02083594",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.