Individual provider Active NPI

Joseph John Cimino, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1790939882
Registry record updated Nov 16, 2008
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
045115 Issued in NY
Practice address
375 Graham Ave
Brooklyn, NY 11211-2409
Phone
(718) 387-0085
Fax
(718) 387-0145
NPI assigned
Nov 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 045115 NY Primary

Addresses

Primary practice location

375 Graham Ave
Brooklyn, NY 11211-2409

Mailing address

375 Graham Ave
Brooklyn, NY 11211-2409
Phone (718) 387-0085

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
I20160113001684 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214239847

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": "1226793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226793600000",
    "number": "1790939882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112112409",
            "telephone_number": "718-387-0085",
            "fax_number": "718-387-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 GRAHAM AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112112409",
            "telephone_number": "718-387-0085",
            "fax_number": "718-387-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMINO",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-16",
        "last_updated": "2008-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "045115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.