Individual provider Active NPI

Steven Richard Cisternas, D.D.S.

  • Dentist
  • Staten Island, NY
National Provider Identifier
1902001811
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
052816 Issued in NY
Practice address
211 Richmond Hill Rd
Staten Island, NY 10314-5905
Phone
(718) 698-3384
Fax
(718) 989-6989
NPI assigned
Jun 19, 2007
Last updated
Jun 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 052816 NY Primary

Addresses

Primary practice location

211 Richmond Hill Rd
Staten Island, NY 10314-5905

Mailing address

211 Richmond Hill Rd
Staten Island, NY 10314-5905
Phone (718) 698-3384

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
I20160106002366 NY Order and Referring Only - DentistPractitioner - Dentist 7012193071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
052816NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Giffords Dental, P.C. Current Accepting new patients
Richmond Hill Dental Design Studio PC CurrentSince Aug 26, 2008 Accepting new patients

Locations

211 Richmond Hill Rd
Staten Island, NY 10314
Phone (718) 698-3384

Organizations & group practices 2

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1902001811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 RICHMOND HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145905",
            "telephone_number": "718-698-3384",
            "fax_number": "718-989-6989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 RICHMOND HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145905",
            "telephone_number": "718-698-3384",
            "fax_number": "718-989-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISTERNAS",
        "first_name": "STEVEN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.