Active NPI
Glenn Charles Simonelli, D.D.S.
- Prosthodontics
- New Hyde Park, NY
National Provider Identifier
1932350451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 421341
- Practice address
- 1 Hollow LN
Suite 202
New Hyde Park, NY 11042-1215 - Phone
- (516) 627-0999
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 421341 | NY | Primary |
Addresses
Primary practice location
1 Hollow LN
Suite 202
New Hyde Park, NY 11042-1215
Mailing address
1 Hollow LN
Suite 202
New Hyde Park, NY 11042-1215
Phone (516) 627-0999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 421341 | NY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prosthodontic Assoc. of Long Island | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- New Hyde Park, NY
- NPI 1386972388
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222905600000",
"number": "1932350451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOLLOW LN",
"address_2": "SUITE 202",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421215",
"telephone_number": "516-627-0999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HOLLOW LN",
"address_2": "SUITE 202",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110421215",
"telephone_number": "516-627-0999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMONELLI",
"first_name": "GLENN",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2008-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NY",
"license": "421341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.