Individual provider Active NPI

Maryanne Nicole Carletto, DDS

  • Dentist
  • Commack, NY
National Provider Identifier
1700104486
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
047536 Issued in NY
Practice address
354 Veterans Memorial Hwy
Ste. 1
Commack, NY 11725-4331
Phone
(631) 543-3146
Fax
(631) 543-3022
NPI assigned
May 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 047536 NY Primary

Addresses

Primary practice location

354 Veterans Memorial Hwy
Ste. 1
Commack, NY 11725-4331

Mailing address

354 Veterans Memorial Hwy
Ste. 1
Commack, NY 11725-4331
Phone (631) 543-3146

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
I20160621001152 NY Order and Referring Only - DentistPractitioner - Dentist 6204127301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047536NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Carletto Dental Dentist Current Accepting new patients
Maryanne N. Carletto, DDS, PC Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273017600000",
    "number": "1700104486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 VETERANS MEMORIAL HWY",
            "address_2": "STE. 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254331",
            "telephone_number": "631-543-3146",
            "fax_number": "631-543-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 VETERANS MEMORIAL HWY",
            "address_2": "STE. 1",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254331",
            "telephone_number": "631-543-3146",
            "fax_number": "631-543-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLETTO",
        "first_name": "MARYANNE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-05",
        "last_updated": "2010-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "047536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

Verify at the official NPI Registry.