Robert Joseph Dietz Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

038399-1 Issued in NY

Practice address

5426 W Genesee St
Camillus, NY 13031-1422

Phone

(315) 487-1545

Fax

(315) 487-1639

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Romans Soltani Dentistry, PLLC

  • General Practice Dentistry
  • Camillus, NY
  • NPI 1821632167
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750305793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PEARTREE DR",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311228",
            "telephone_number": "315-488-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311422",
            "telephone_number": "315-487-1545",
            "fax_number": "315-487-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIETZ",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "038399-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annamaria Demichele, D.D.S.
• Cathy Lee Depaulis, MS,CCC-SLP
• Noelle Lynn Desantis, MS, CCC-SLP
• Shelby Deuel, RN BSN
• Amy E Dewitt
• Patrick Digirolamo, LCSW
• Alissa Marie Dippolito-Tripp, FNP
• DME Consulting Agency LLC (Kinney Homecare Equipment and Supplies)
• Samantha Donald, RD
• Jack L. Donaldson

• General Practice Dentistry in Camillus, NY
• Providers in Camillus, 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 Jul 8, 2007; 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.