Active NPI
Joseph Michael Cristoforo, D.D.S.
- Periodontics
- Massapequa Park, NY
National Provider Identifier
1952522641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 041464
- Practice address
- 1035 Park Boulevard
Suite 1E
Massapequa Park, NY 11762 - Phone
- (516) 798-5700
- Fax
- (516) 798-5988
- NPI assigned
- May 1, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 041464 | NY | Primary |
Addresses
Primary practice location
1035 Park Boulevard
Suite 1E
Massapequa Park, NY 11762
Mailing address
1035 Park Boulevard
Suite 1E
Massapequa Park, NY 11762
Phone (516) 798-5700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141205001770 | WI | Order and Referring Only - Oral Surgery | 9537481346 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041464 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952522641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1035 PARK BOULEVARD",
"address_2": "SUITE 1E",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "11762",
"telephone_number": "516-798-5700",
"fax_number": "516-798-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 PARK BOULEVARD",
"address_2": "SUITE 1E",
"city": "MASSAPEQUA PARK",
"state": "NY",
"postal_code": "11762",
"telephone_number": "516-798-5700",
"fax_number": "516-798-5988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISTOFORO",
"first_name": "JOSEPH",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "041464",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Massapequa Park, NY
- Matthew Dante Cosentino, LMHC-D
- Jill Susan Costa, P.T.
- Richard Joseph Cowan, P.T.
- Lauren Crespo, P.T.
- Theresa Ann Cretella, MSED
- CS Medical Associates, P.C. (Victory Recovery Partners)
- Patricia A Cummings, RPH
- Margaret Mary Curley, MS, CCC-SLP
- Mary Cutrone-Foley, LPTA, ATP
- Joseph Paul Dabovich II, P.T.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.