Individual provider Active NPI

Dino Michael Defilippis, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • New Rochelle, NY
National Provider Identifier
1568451250
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
040907 Issued in NY
Practice address
140 Lockwood Ave Ste 318
New Rochelle, NY 10801-4909
Phone
(914) 637-9600
NPI assigned
Oct 17, 2005
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 040907 NY Primary

Addresses

Primary practice location

140 Lockwood Ave Ste 318
New Rochelle, NY 10801-4909

Mailing address

140 Lockwood Ave Ste 318
New Rochelle, NY 10801-4909
Phone (914) 637-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214000142 NY Order and Referring Only - DentistPractitioner - Dentist 6608177811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040907NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Shore Oral & Maxillofacial Surgery, P.C. PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1568451250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE STE 318",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014909",
            "telephone_number": "914-637-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LOCKWOOD AVE STE 318",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014909",
            "telephone_number": "914-637-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFILIPPIS",
        "first_name": "DINO",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "040907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.