Active NPI
Antony Desantis, DDS
- General Practice Dentistry
- Albany, NY
National Provider Identifier
1790915726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 054426
- Practice address
- 1092 Madison Ave
Albany, NY 12208-2248 - Phone
- (518) 525-1757
- NPI assigned
- Jul 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 054426 | NY | Primary |
Addresses
Primary practice location
1092 Madison Ave
Albany, NY 12208-2248
Mailing address
73 Troy Rd 1D
East Greenbush, NY 12061-1334
Phone (518) 451-9770
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151229000521 | NY | Order and Referring Only - Dentist | 8224227848 |
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": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450051200000",
"number": "1790915726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 TROY RD 1D",
"city": "EAST GREENBUSH",
"state": "NY",
"postal_code": "120611334",
"telephone_number": "518-451-9770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1092 MADISON AVE",
"city": "ALBANY",
"state": "NY",
"postal_code": "122082248",
"telephone_number": "518-525-1757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANTIS",
"first_name": "ANTONY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-24",
"last_updated": "2015-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "054426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.