Phillip Parker, DDS

Primary specialty

Advanced Practice Dental TherapistTaxonomy code 125K00000X

License

040 171 1 Issued in NY

Practice address

3669 Main St
Stone Ridge, NY 12484-5613

Phone

(845) 687-0066

NPI assigned

Jul 25, 2014

Last updated

Jul 25, 2014By the provider in NPPES

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phillip E. Parker, D.D.S., PC

  • Dentist
  • Stone Ridge, NY
  • NPI 1013233832
  NPD (past) Authorized official

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406246400000",
    "number": "1902214604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 TWIN PONDS DR",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124016432",
            "telephone_number": "845-338-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3669 MAIN ST",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "124845613",
            "telephone_number": "845-687-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "PHILLIP",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125K00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Dental Therapist",
            "state": "NY",
            "license": "040 171 1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauri A Mulholland, RN
• Megan Murphy, M.S., CCC-SLP
• Helena Nikolajevic, LAC
• Kelly Oconnell
• Deepak Parikh, MD
• Peter James Petrulis, D.O.
• Phillip E. Parker, D.D.S., PC
• Kevin Paul Placentino, RPH
• Priscilla Alden Reynolds, R.N., F.N.P.
• Tiffany Robinson

• Advanced Practice Dental Therapist in Stone Ridge, NY
• Providers in Stone Ridge, NY by specialty
• Advanced Practice Dental Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.