Individual provider Active NPI

Alexi Damascus, D.D.S.

  • Pediatric Dentistry
  • Chappaqua, NY
National Provider Identifier
1477837128
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
055747 Issued in NY
Practice address
59 S Greeley Ave
Chappaqua, NY 10514-3321
Phone
(917) 612-0579
NPI assigned
Sep 29, 2011
Last updated
Sep 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 055747 NY Primary

Addresses

Primary practice location

59 S Greeley Ave
Chappaqua, NY 10514-3321

Mailing address

59 S Greeley Ave
Chappaqua, NY 10514-3321
Phone (917) 612-0579

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
055747NYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1477837128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 S GREELEY AVE",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105143321",
            "telephone_number": "917-612-0579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 S GREELEY AVE",
            "city": "CHAPPAQUA",
            "state": "NY",
            "postal_code": "105143321",
            "telephone_number": "917-612-0579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMASCUS",
        "first_name": "ALEXI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chappaqua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; 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.