Maricarmen Justiniano, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

053197-1 Issued in NY

Practice address

5875 S Transit Rd
Lockport, NY 14094-6340

Phone

(716) 280-1001

Fax

(716) 280-1005

NPI assigned

Aug 22, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1497948475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 SAINT ANTHONY ST",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140862388",
            "telephone_number": "716-208-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 S TRANSIT RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140946340",
            "telephone_number": "716-280-1001",
            "fax_number": "716-280-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANO",
        "first_name": "MARICARMEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053197-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Lockport, NY
• Providers in Lockport, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.