Individual provider Active NPI

Maria Vartholomeos, DDS

  • Dentist
  • Whitestone, NY
National Provider Identifier
1598740789
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047509 Issued in NY
Practice address
15005 21 Ave
Whitestone, NY 11357-2306
Phone
(718) 353-5853
Fax
(718) 353-5947
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047509 NY Primary

Addresses

Primary practice location

15005 21 Ave
Whitestone, NY 11357-2306

Mailing address

15005 21 Ave
Whitestone, NY 11357-2306
Phone (718) 353-5853

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
I20150721001659 NY Order and Referring Only - DentistPractitioner - Dentist 3476866336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047509NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph L. Mollura, M.D., F.a.C.P., P.C. Past 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": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1598740789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15005 21 AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572306",
            "telephone_number": "718-353-5853",
            "fax_number": "718-353-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15005 21 AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113572306",
            "telephone_number": "718-353-5853",
            "fax_number": "718-353-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTHOLOMEOS",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitestone, NY

Sources for this page

Verify at the official NPI Registry.