Individual provider Active NPI

Paul Dominic Verdi, DDS

  • General Practice Dentistry
  • Port Washington, NY
National Provider Identifier
1508063264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040923-1 Issued in NY
Practice address
14 Vanderventer Ave
Suite 140
Port Washington, NY 11050-3737
Phone
(516) 767-3353
Fax
(516) 767-3290
NPI assigned
Jun 27, 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
General Practice Dentistry 1223G0001X 040923-1 NY Primary

Addresses

Primary practice location

14 Vanderventer Ave
Suite 140
Port Washington, NY 11050-3737

Mailing address

14 Vanderventer Ave
Suite 140
Port Washington, NY 11050-3737
Phone (516) 767-3353

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
040923-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508063264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 VANDERVENTER AVE",
            "address_2": "SUITE 140",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503737",
            "telephone_number": "516-767-3353",
            "fax_number": "516-767-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 VANDERVENTER AVE",
            "address_2": "SUITE 140",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110503737",
            "telephone_number": "516-767-3353",
            "fax_number": "516-767-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDI",
        "first_name": "PAUL",
        "middle_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040923-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.