Active NPI
Vito Giovanniello, DDS
- Dentist
- Lake Ronkonkoma, NY
National Provider Identifier
1659486371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0264061
- Practice address
- 469 Hawkins Avenue
Suite 101
Lake Ronkonkoma, NY 11779-4273 - Phone
- (631) 588-8280
- Fax
- (631) 588-6258
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0264061 | NY | Primary |
Addresses
Primary practice location
469 Hawkins Avenue
Suite 101
Lake Ronkonkoma, NY 11779-4273
Mailing address
469 Hawkins Avenue
Suite 101
Lake Ronkonkoma, NY 11779-4273
Phone (631) 588-8280
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0264061 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sachem Dental Group | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Lake Ronkonkoma, NY
- NPI 1568478196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659486371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "469 HAWKINS AVENUE",
"address_2": "SUITE 101",
"city": "LAKE RONKONKOMA",
"state": "NY",
"postal_code": "117794273",
"telephone_number": "631-588-8280",
"fax_number": "631-588-6258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "469 HAWKINS AVENUE",
"address_2": "SUITE 101",
"city": "LAKE RONKONKOMA",
"state": "NY",
"postal_code": "117794273",
"telephone_number": "631-588-8280",
"fax_number": "631-588-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIOVANNIELLO",
"first_name": "VITO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0264061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Ronkonkoma, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.