Active NPI
Jeffrey Mark Deluccia, DDS
- Dentist
- Massapequa, NY
National Provider Identifier
1558532036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0485521
- Practice address
- 5240 Merrick Road
Massapequa, NY 11758-6207 - Phone
- (516) 798-2020
- Fax
- (516) 798-2237
- NPI assigned
- Mar 12, 2008
- Last updated
- May 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0485521 | NY | Primary |
Addresses
Primary practice location
5240 Merrick Road
Massapequa, NY 11758-6207
Mailing address
5240 Merrick Road
Massapequa, NY 11758-6207
Phone (516) 798-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0485521 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305849600000",
"number": "1558532036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5240 MERRICK ROAD",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117586207",
"telephone_number": "516-798-2020",
"fax_number": "516-798-2237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5240 MERRICK ROAD",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117586207",
"telephone_number": "516-798-2020",
"fax_number": "516-798-2237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCCIA",
"first_name": "JEFFREY",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-12",
"last_updated": "2011-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0485521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massapequa, NY
- Caroline Defina
- Beverley Gillian Del Greco, M.S. ED
- Desiree Victoria Delacruz, LMHC
- Ivette Ann Delerme
- Natalia Maria Delgado
- Gabriella Delwey, MS, OTR/L
- Michael Demartino, M.D.
- Rhyne Champ Dengenis, D.O.
- Jessica Denicola, PMHNP-BC
- Denise Wright Licensed Behavior Analyst PLLC (Applied Behavior Analysis Team)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.