Individual provider Active NPI

Paul Anthony Patella, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Hartsdale, NY
National Provider Identifier
1639173040
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
029239 Issued in NY
Practice address
280 Central Park Ave
Suite 307
Hartsdale, NY 10530
Phone
(914) 997-7688
Fax
(914) 987-9438
NPI assigned
Jun 13, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 Pathology Dentistry 1223P0106X 029239 NY Primary

Addresses

Primary practice location

280 Central Park Ave
Suite 307
Hartsdale, NY 10530

Mailing address

280 Central Park Ave
Suite 307
Hartsdale, NY 10530
Phone (914) 997-7688

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
I20040823000286 NY Practitioner - Oral Surgery 2860466257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Implant & Oral Surgery, PC Oral and Maxillofacial Pathology CurrentSince Aug 17, 2016 Accepting new patients

Locations

27 Hospital Ave
Ste 306
Danbury, CT 06810
Phone (203) 797-0008

27 Hospital Ave
Ste 203
Danbury, CT 06810
Phone (203) 797-0008

666 Lexington Ave
Ste 203
Mount Kisco, NY 10549
Phone (203) 797-0008

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639173040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CENTRAL PARK AVE",
            "address_2": "SUITE 307",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "10530",
            "telephone_number": "914-997-7688",
            "fax_number": "914-987-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 CENTRAL PARK AVE",
            "address_2": "SUITE 307",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "10530",
            "telephone_number": "914-997-7688",
            "fax_number": "914-987-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATELLA",
        "first_name": "PAUL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NY",
            "license": "029239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsdale, NY

Sources for this page

Verify at the official NPI Registry.