Individual provider Active NPI

Marichia A Attalla, D.D.S

  • Periodontics
  • Babylon, NY
National Provider Identifier
1801930128
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
050262-NY Issued in NY
Practice address
678 Deer Park Ave
Babylon, NY 11702-1319
Phone
(631) 587-5870
NPI assigned
Feb 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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
Periodontics 1223P0300X 050262-NY NY Primary

Addresses

Primary practice location

678 Deer Park Ave
Babylon, NY 11702-1319

Mailing address

124 Hayrick LN
Commack, NY 11725-1526
Phone (631) 486-2652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
050262-NYNYMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Arnold M. Lieberman, DDS & Vasilios D. Mesimeris, DMD PC Periodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801930128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 HAYRICK LN",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117251526",
            "telephone_number": "631-486-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 DEER PARK AVE",
            "city": "BABYLON",
            "state": "NY",
            "postal_code": "117021319",
            "telephone_number": "631-587-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTALLA",
        "first_name": "MARICHIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "050262-NY",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Babylon, NY

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.