Active NPI
Johnny Nico Atencio, BS
- Dentist
- Dover Afb, DE
National Provider Identifier
1942997176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN.00205615
- Practice address
- 300 Tuskegee Blvd
Dover Afb, DE 19902-5003 - Phone
- (302) 730-4633
- NPI assigned
- Apr 18, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Dentist | 122300000X | DEN.00205615 | CO | Primary |
Addresses
Primary practice location
300 Tuskegee Blvd
Dover Afb, DE 19902-5003
Mailing address
300 Tuskegee Blvd
Dover Afb, DE 19902-5003
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00205615 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722211200000",
"number": "1942997176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 TUSKEGEE BLVD",
"city": "DOVER AFB",
"state": "DE",
"postal_code": "199025003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 TUSKEGEE BLVD",
"city": "DOVER AFB",
"state": "DE",
"postal_code": "199025003",
"telephone_number": "302-730-4633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATENCIO",
"first_name": "JOHNNY",
"middle_name": "NICO",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-18",
"last_updated": "2024-07-29",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00205615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dover Afb, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.