Individual provider Active NPI

Dennis Fedele, D.D.S

  • General Practice Dentistry
  • Mamaroneck, NY
National Provider Identifier
1699895359
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
036170-1 Issued in NY
Practice address
444 E Boston Post Rd Ste 208
Mamaroneck, NY 10543-3704
Phone
(914) 698-2733
Fax
(914) 698-2733
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 036170-1 NY Primary

Addresses

Primary practice location

444 E Boston Post Rd Ste 208
Mamaroneck, NY 10543-3704

Mailing address

122 Studio Rd
Stamford, CT 06903-4721
Phone (203) 968-0244

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
036170-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699895359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 STUDIO RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069034721",
            "telephone_number": "203-968-0244",
            "fax_number": "914-698-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 E BOSTON POST RD STE 208",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105433704",
            "telephone_number": "914-698-2733",
            "fax_number": "914-698-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELE",
        "first_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036170-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, 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.

Verify at the official NPI Registry.