Ralph Defelice, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27450 Issued in NY

Practice address

404 William St
Geneva, NY 14456-2143

Phone

(315) 789-3067

Fax

(315) 789-0056

NPI assigned

May 21, 2007

Sex

Male

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

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.

Opted out of Medicare

Yes, effective Feb 10, 2016 through Feb 10, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Lake Country Dental P.L.L.C

  • Dental Clinic/Center
  • Geneva, NY
  • NPI 1396274452
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497964191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 WILLIAM ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562143",
            "telephone_number": "315-789-3067",
            "fax_number": "315-789-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 WILLIAM ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144562143",
            "telephone_number": "315-789-3067",
            "fax_number": "315-789-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFELICE",
        "first_name": "RALPH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "27450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siobhan B De Urioste, PHARMD
• William Hope Dean Jr., M.D.
• Debra a. Byers, DMD, PC
• Michael J Decicco, MD
• Ann Decker
• Thomas Joseph Delpapa, PT, DPT
• Reihaneh Derafsh, M.D
• Carole L Derry-Oaks, RPH
• Melissa Dhundale, M.D.
• Angel A. Diaz, M.D.

• General Practice Dentistry in Geneva, NY
• Providers in Geneva, 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 Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.