Individual provider Active NPI

Joann M. Deleonibus, DMD

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1629147335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
040747-1 Issued in NY
Practice address
139 Clinton St
Brooklyn, NY 11201-4616
Phone
(718) 625-6437
Fax
(718) 624-5711
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

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 040747-1 NY Primary

Addresses

Primary practice location

139 Clinton St
Brooklyn, NY 11201-4616

Mailing address

139 Clinton St
Brooklyn, NY 11201-4616
Phone (718) 625-6437

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
I20150224000395 NY Order and Referring Only - DentistPractitioner - Dentist 8123344843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040747-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629147335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CLINTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014616",
            "telephone_number": "718-625-6437",
            "fax_number": "718-624-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CLINTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014616",
            "telephone_number": "718-625-6437",
            "fax_number": "718-624-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEONIBUS",
        "first_name": "JOANN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "040747-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.