Individual provider Active NPI

Stephen J. Vuolo, D.D.S.

  • Dentist
  • Garden City, NY
National Provider Identifier
1497874416
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
040074 Issued in NY
Practice address
520 Franklin Ave
Suite L-12
Garden City, NY 11530-5801
Phone
(516) 294-0050
Fax
(516) 280-5218
NPI assigned
Mar 29, 2007
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
Dentist 122300000X 040074 NY Primary

Addresses

Primary practice location

520 Franklin Ave
Suite L-12
Garden City, NY 11530-5801

Mailing address

8 Driftwood LN
Dix Hills, NY 11746-7940
Phone (631) 462-6438

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
I20240410002710 NY Order and Referring Only - DentistPractitioner - Dentist 2062850985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497874416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 DRIFTWOOD LN",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117467940",
            "telephone_number": "631-462-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 FRANKLIN AVE",
            "address_2": "SUITE L-12",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115305801",
            "telephone_number": "516-294-0050",
            "fax_number": "516-280-5218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUOLO",
        "first_name": "STEPHEN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.