Individual provider Active NPI

Dorothy Marie Cutolo, DDS

  • General Practice Dentistry
  • Massapequa, NY
National Provider Identifier
1720111446
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042094 Issued in NY
Practice address
708 Broadway
Suite One
Massapequa, NY 11758-2326
Phone
(516) 798-1900
Fax
(516) 798-4506
NPI assigned
Mar 13, 2007
Sex
Female
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 042094 NY Primary

Addresses

Primary practice location

708 Broadway
Suite One
Massapequa, NY 11758-2326

Mailing address

708 Broadway
Suite One
Massapequa, NY 11758-2326
Phone (516) 798-1900

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
I20150616000092 NY Order and Referring Only - DentistPractitioner - Dentist 5597076752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042094NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720111446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BROADWAY",
            "address_2": "SUITE ONE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582326",
            "telephone_number": "516-798-1900",
            "fax_number": "516-798-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 BROADWAY",
            "address_2": "SUITE ONE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117582326",
            "telephone_number": "516-798-1900",
            "fax_number": "516-798-4506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUTOLO",
        "first_name": "DOROTHY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

Verify at the official NPI Registry.