Individual provider Active NPI

Michelle Policastro

  • General Practice Dentistry
  • Rocky Point, NY
National Provider Identifier
1639336761
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
052342 Issued in NY
Practice address
347 Route 25a Ste 1
Rocky Point, NY 11778-7911
Phone
(631) 744-3088
Fax
(631) 744-3099
NPI assigned
May 16, 2008
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 052342 NY Primary

Addresses

Primary practice location

347 Route 25a Ste 1
Rocky Point, NY 11778-7911

Mailing address

347 Route 25a Ste 1
Rocky Point, NY 11778-7911
Phone (631) 744-3088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
052342NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1639336761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 ROUTE 25A STE 1",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117787911",
            "telephone_number": "631-744-3088",
            "fax_number": "631-744-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 ROUTE 25A STE 1",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117787911",
            "telephone_number": "631-744-3088",
            "fax_number": "631-744-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICASTRO",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-16",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "052342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.