Mario Roberto Denicola, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401415736 Issued in VA

Practice address

1451 Brookhaven Dr
Rockingham, VA 22801

Phone

(585) 732-0039

NPI assigned

Jun 12, 2014

Last updated

Jun 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1497169015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 BROOKHAVEN DR",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228013584",
            "telephone_number": "585-732-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 BROOKHAVEN DR",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "22801",
            "telephone_number": "585-732-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICOLA",
        "first_name": "MARIO",
        "middle_name": "ROBERTO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401415736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billie Jo Day, RN
• Philip W. Day, M.D.
• Laura Deavers, PHARMD
• Marisol Delgado Alvarez, LPN
• Denicola Khanna DDS, PLLC
• Amy Homan Depoy, OT/L
• Nicole Didomenico, M.A., CCC-SLP
• Julia Mackenzie Diehl, PA-C
• Amber Belle Dodson, FNP-C
• Aimee Noel Doyle, OTD

• General Practice Dentistry in Rockingham, VA
• Providers in Rockingham, VA by specialty
• General Practice Dentistry in Virginia

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

Verify at the official NPI Registry.