Individual provider Active NPI

Michael Anthony Nastasi, D.D.S.

  • General Practice Dentistry
  • Valley Stream, NY
National Provider Identifier
1528241817
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
045846-1 Issued in NY
Practice address
453 Rockaway Ave
Valley Stream, NY 11581-1909
Phone
(516) 825-3884
Fax
(516) 568-0696
NPI assigned
Dec 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 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 045846-1 NY Primary

Addresses

Primary practice location

453 Rockaway Ave
Valley Stream, NY 11581-1909

Mailing address

453 Rockaway Ave
Valley Stream, NY 11581-1909
Phone (516) 825-3884

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
045846-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1528241817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 ROCKAWAY AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811909",
            "telephone_number": "516-825-3884",
            "fax_number": "516-568-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 ROCKAWAY AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811909",
            "telephone_number": "516-825-3884",
            "fax_number": "516-568-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASTASI",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045846-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.