Individual provider Active NPI

Joseph T Mormino, DDS

  • General Practice Dentistry
  • Staten Island, NY
National Provider Identifier
1740370956
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042434 Issued in NY
Practice address
104 Windsor Rd
Staten Island, NY 10314-4541
Phone
(718) 876-9100
Fax
(718) 876-8888
NPI assigned
Oct 16, 2006
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 042434 NY Primary

Addresses

Primary practice location

104 Windsor Rd
Staten Island, NY 10314-4541

Mailing address

104 Windsor Rd
Staten Island, NY 10314-4541
Phone (718) 876-9100

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
I20150519000189 NY Order and Referring Only - DentistPractitioner - Dentist 6305166174

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740370956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WINDSOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144541",
            "telephone_number": "718-876-9100",
            "fax_number": "718-876-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WINDSOR RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144541",
            "telephone_number": "718-876-9100",
            "fax_number": "718-876-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORMINO",
        "first_name": "JOSEPH",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "042434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.