Antonio Ardisana, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

034831 Issued in NY

Practice address

8710 Grand Ave
Elmhurst, NY 11373-4444

Phone

(718) 429-8300

Fax

(516) 822-2396

NPI assigned

May 29, 2007

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

Other identifiers 1

Other names 1

• Anthony Ardisana Former name

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.

• Exceldent Dental of Western Sullivan LLP

  • Dentist
  • Liberty, NY
  • NPI 1245529874
  NPD (past)
• Jules V. Lane, DDS

  • General Practice Dentistry
  • Elmhurst, NY
  • NPI 1659360881
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1861693871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 TRIANGLE RD",
            "city": "LIBERTY",
            "state": "NY",
            "postal_code": "12754",
            "telephone_number": "845-292-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8710 GRAND AVE",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734444",
            "telephone_number": "718-429-8300",
            "fax_number": "516-822-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDISANA",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00487994",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTHONY",
            "last_name": "ARDISANA",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Aliza Applebaum, PA-C
• Jessica Aquino-Lopez, CASAC
• Ar NP in Family Health PLLC
• Kazi Jannath Ara, DO
• Stella Arabov, PA
• Luz Delia Ares, M.D.
• Carlos Arevalo, M.D.
• Omar Adolfo Argueta
• Arlene B. Mercado, M.D.
• Jamen Armendariz, OTR

• General Practice Dentistry in Elmhurst, NY
• Providers in Elmhurst, 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 8, 2019; 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.