Alfonso John Merola IV, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

058554 Issued in NY

Practice address

5100 W Taft Rd Ste 3K
Liverpool, NY 13088-3809

Phone

(315) 452-2700

Fax

(315) 452-2705

NPI assigned

Apr 23, 2015

Sex

Male

Sole proprietor

No

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.

• NMC General Dentistry, PC

  • General Practice Dentistry
  • Liverpool, NY
  • NPI 1780715201
  NPD (past) Authorized official

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1851788137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 3K",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883809",
            "telephone_number": "315-452-2700",
            "fax_number": "315-452-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W TAFT RD STE 3K",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130883809",
            "telephone_number": "315-452-2700",
            "fax_number": "315-452-2705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEROLA",
        "first_name": "ALFONSO",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott D Mendzef, NP
• Dante Mento, PHARMD, RPH
• John Anthony Mercurio Sr.
• Meridian Chiropractic & Wellness, PC
• A.John Merola, MD
• Herbert A Merrick, CRPA, CARC
• Laura Anne Messina, LPN
• Michael Couch Jr DPM
• John W Michaels, MD
• Lauren Michaels, DPT

• General Practice Dentistry in Liverpool, NY
• Providers in Liverpool, 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 Aug 15, 2016; 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.