Individual provider Active NPI

Anthony P Laudano, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • West Springfield, MA
National Provider Identifier
1629154869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
21663 Issued in MA
Practice address
75 Van Deene Ave
Suite 201
West Springfield, MA 01089
Phone
(413) 788-9621
Fax
(413) 788-0103
NPI assigned
Oct 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 21663 MA Primary

Addresses

Primary practice location

75 Van Deene Ave
Suite 201
West Springfield, MA 01089

Mailing address

75 Van Deene Ave
Suite 201
West Springfield, MA 01089
Phone (413) 788-9621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20070328000563 MA Practitioner - Oral Surgery 1052415296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21663MAMDOral and Maxillofacial Surgery (Dentist)

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": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629154869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VAN DEENE AVE",
            "address_2": "SUITE 201",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-788-9621",
            "fax_number": "413-788-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VAN DEENE AVE",
            "address_2": "SUITE 201",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-788-9621",
            "fax_number": "413-788-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDANO",
        "first_name": "ANTHONY",
        "middle_name": "P",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "21663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

Verify at the official NPI Registry.