Individual provider Active NPI

Daniel J Palermo, DDS

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1609977289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
041415-1 Issued in NY
Practice address
3770 Mount Read Blvd
Rochester, NY 14616-3436
Phone
(585) 865-7030
Fax
(585) 865-1425
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

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 041415-1 NY Primary

Addresses

Primary practice location

3770 Mount Read Blvd
Rochester, NY 14616-3436

Mailing address

3770 Mount Read Blvd
Rochester, NY 14616-3436
Phone (585) 865-7030

Other identifiers 1

IdentifierTypeStateIssuer
7961OtherNYBCBS IDENTIFIER

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
I20160212000498 NY Order and Referring Only - DentistPractitioner - Dentist 9133423056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041415-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Dental, LLP General Practice Past Accepting new patients
Cornerstone Dental of Henrietta General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609977289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 MOUNT READ BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163436",
            "telephone_number": "585-865-7030",
            "fax_number": "585-865-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 MOUNT READ BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146163436",
            "telephone_number": "585-865-7030",
            "fax_number": "585-865-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALERMO",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041415-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IDENTIFIER",
            "identifier": "7961",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.