DR. DOMENIC RICCOBONO (NPI# 1578677175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578677175 |
| Entity Type | Individual |
| Full Name | DR. DOMENIC RICCOBONO |
| Credential | DDS |
| Practice Address |
42 Kinderhook St Chatham NY 12037-1207 |
| Practice Telephone | 5183925231 |
| Practice Fax Number | 5183927339 |
| Mailing Telephone | 5183925231 |
| Mailing Fax Number | 5183927339 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
045941 | NY | Dental Providers |
| Street Address |
42 KINDERHOOK ST |
| City | CHATHAM |
| State | NY |
| Zip Code | 12037-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952558074 | Countryside Dental | Dentist | 42 Kinderhook St, Chatham, NY 12037-1207 | 2008-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740666585 | Jillian Leigh Faxon | Pharmacist | 15 Coleman Street, Chatham, NY 12037 | 2015-08-04 |
| 1962899401 | Cindy C Dodge | Physical Therapist | 5 Roxbury Rd., Chatham Physical Therapy, Chatham, NY 12037 | 2015-04-22 |
| 1194946681 | Timothy John Mullen | Mechanotherapist | 25 Kinderhook Street, Chatham, NY 12037 | 2007-05-01 |
| 1285776690 | Colin H Heeps | Dentist | 1 Houseman Avenue, Chatham, NY 12037 | 2007-02-13 |
| 1871631705 | Yasamin Larizadeh | Social Worker | 607 State Route 295, Suite 7, Chatham, NY 12037 | 2007-02-02 |
| 1225079122 | Amy Surman | Physician Assistant | 31 Dardess Drive, Chatham, NY 12037 | 2006-06-10 |
| 1841609393 | Amy K Bartlett-palmer | Nurse Practitioner | 29 Jones Ave, Chatham, NY 12037 | 2014-08-08 |
| 1407962244 | Tracy Blatney | Massage Therapist | 19 Hudson Ave, Chatham, NY 12037-1110 | 2006-08-22 |
| 1508314048 | Integrity Chiropractic Wellness | Chiropractor | 19 Hudson Ave, Chatham, NY 12037-1110 | 2016-09-13 |
| 1932551298 | Paula Jane Daigle | Chiropractor | 19 Hudson Ave, Chatham, NY 12037-1110 | 2016-07-11 |
| Find all providers in zip 12037 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326214628 | Catherine M Stuzynski | Dentist | 15 Stonewyck Drive, Chatham, NJ 07928-1321 | 2008-05-06 |
| 1144436445 | Douglas Sumpter Price Jr. | Dentist | 19144 Hwy 29 North, Chatham, VA 24531-1139 | 2007-05-15 |
| 1104949064 | Kevin P. Dougherty, Dmd, Pa | Dentist | 475 Shunpike Rd, Chatham, NJ 07928-1528 | 2007-04-07 |
| 1548393341 | Jonathan P Mundth | Dentist | 140 Main Street, Chatham, NJ 07928-2418 | 2007-03-13 |
| 1275640724 | Robert Thomas Montbach | Dentist | 720 Main Street, Chatham, MA 02633 | 2006-08-23 |
| 1962518860 | Jean Corriveau | Dentist | 1209 N. Main St., Chatham, IL 62629 | 2006-08-22 |
| 1326062514 | Justin C Rivers | Dentist | 92 Crowell Rd, Chatham, MA 02633-1966 | 2006-07-27 |
| 1013984053 | Howard Charles Schwartz | Dentist | 466 Southern Blvd, Chatham, NJ 07928-1462 | 2006-03-08 |
| 1184024176 | Sara Rankin | Dentist | 390 Main St, Chatham, NJ 07928-2112 | 2014-08-27 |
| 1386058451 | Paul W Miller Dds Plc | Dentist | 6 S Main St, Chatham, VA 24531-5436 | 2014-06-17 |
| Find all providers in CHATHAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.