Provider Demographics
NPI:1821036088
Name:LAPENTA, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:LAPENTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-2225
Mailing Address - Country:US
Mailing Address - Phone:802-447-8700
Mailing Address - Fax:802-447-1500
Practice Address - Street 1:322 DEWEY ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2225
Practice Address - Country:US
Practice Address - Phone:802-447-8700
Practice Address - Fax:802-447-1500
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA53383207W00000X
VT0420007142207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00922427Medicaid
MA10001135OtherCDPHP
VT13787OtherHNE
MA17138OtherMVP
MAJ12264OtherMABS
VT053383OtherTUFTS
MA13787OtherHNE
VTVT6085OtherVTBS
VT000000024108OtherBMC
MA053383OtherTUFTS
VT10001135OtherCDPHP
VT17138OtherMVP
MA000000024106OtherBMC
VT0006085Medicaid
MA110045159AMedicaid
MAP00705216Medicare PIN
MAJ12264OtherMABS
VT13787OtherHNE
VTDX7028Medicare PIN
MADX4647Medicare PIN
MAB85439Medicare UPIN