Individual provider Active NPI

William Paul Piscitelli, D.D.S.

  • Pediatric Dentistry
  • Richmond, VA
National Provider Identifier
1891718557
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0401411742 Issued in VA
Practice address
6900 Forest Ave
Suite 110
Richmond, VA 23230-1729
Phone
(804) 893-8715
Fax
(804) 285-1292
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2994 WV
Pediatric Dentistry 1223P0221X 0401411742 VA Primary

Addresses

Primary practice location

6900 Forest Ave
Suite 110
Richmond, VA 23230-1729

Mailing address

6900 Forest Ave
Suite 110
Richmond, VA 23230-1729
Phone (804) 893-8715

Other identifiers 2

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN
0138580000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20140630001259 VA Practitioner - Oral Surgery 3971728288 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401411742VAMDPediatric Dentist
2994WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Jun 1, 2014 Accepting new patients
Bon Secours St. Mary'S Hospital of Richmond LLC Current Accepting new patients
Bon Secours St Mary'S Hospital of Richmond LLC Pediatric Dentistry CurrentSince Jun 1, 2014 Accepting new patients
Bon Secours-St. Mary'S Hospital of Richmond, Inc. Past Accepting new patients

Locations

6900 Forest Ave
Ste 110
Richmond, VA 23230
Phone (804) 893-8692

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

Interoperability endpoints

  • Direct secure messaging: wpiscitelli1154710@direct.bsmhealth.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1891718557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 FOREST AVE",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301729",
            "telephone_number": "804-893-8715",
            "fax_number": "804-285-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 FOREST AVE",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301729",
            "telephone_number": "804-893-8715",
            "fax_number": "804-285-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISCITELLI",
        "first_name": "WILLIAM",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "2994",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401411742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0138580000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.