Individual provider Active NPI

John Joseph Tolli, DDS

  • Dentist
  • Amawalk, NY
National Provider Identifier
1659535763
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
032266 Issued in NY
Practice address
68 Mahopac Ave
Amawalk, NY 10501-1014
Phone
(914) 962-6447
NPI assigned
Jul 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 032266 NY Primary

Addresses

Primary practice location

68 Mahopac Ave
Amawalk, NY 10501-1014

Mailing address

68 Mahopac Ave
Amawalk, NY 10501-1014
Phone (914) 962-6447

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
I20160308000642 NY Order and Referring Only - DentistPractitioner - Dentist 4981900552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1659535763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 MAHOPAC AVE",
            "city": "AMAWALK",
            "state": "NY",
            "postal_code": "105011014",
            "telephone_number": "914-962-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 MAHOPAC AVE",
            "city": "AMAWALK",
            "state": "NY",
            "postal_code": "105011014",
            "telephone_number": "914-962-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLLI",
        "first_name": "JOHN",
        "middle_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "032266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amawalk, NY

Sources for this page

Verify at the official NPI Registry.