Anthony J Mendicino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42164 Issued in NY

Practice address

6692 Middle Rd
Suite 2100
Sodus, NY 14551-9602

Phone

(315) 483-1199

Fax

(315) 483-2451

NPI assigned

Sep 25, 2006

Last updated

Feb 16, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Finger Lakes Community Health

  dba Dundee Community Health

  • Federally Qualified Health Center (FQHC)
  • Dundee, NY
  • NPI 1366939878
  NPD (past)
• Finger Lakes Community Health

  • Federally Qualified Health Center (FQHC)
  • Sodus, NY
  • NPI 1669568465
  NPD (past)
• Finger Lakes Migrant Health Care Project, Inc.

  dba Penn Yan School-Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Penn Yan, NY
  • NPI 1417643453
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1699876730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 423",
            "city": "PENN YAN",
            "state": "NY",
            "postal_code": "145270423",
            "telephone_number": "315-531-9102",
            "fax_number": "315-531-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6692 MIDDLE RD",
            "address_2": "SUITE 2100",
            "city": "SODUS",
            "state": "NY",
            "postal_code": "145519602",
            "telephone_number": "315-483-1199",
            "fax_number": "315-483-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDICINO",
        "first_name": "ANTHONY",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "42164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02562825",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS SODUS SITE",
            "identifier": "70461FL",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS GENEVA SITE",
            "identifier": "70503GH",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Lehfeldt, D.D.S.
• Dawn Marie Leone, OTR/L
• Heather Lobrutto, PNP
• Rene McCabe, LPN
• Amy Naomy Melendez
• Corey M Meyn, NP
• MG Dodge Chiropractic, PC
• Manuela Milliman, RN
• Jennifer Monna, PA
• Faig William Morgos, MD

• General Practice Dentistry in Sodus, NY
• Providers in Sodus, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.