Provider Demographics
NPI:1013958065
Name:DINARDO, NEBRIDIO MARIO (DMD)
Entity type:Individual
Prefix:DR
First Name:NEBRIDIO
Middle Name:MARIO
Last Name:DINARDO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1947 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3339
Mailing Address - Country:US
Mailing Address - Phone:716-675-9777
Mailing Address - Fax:716-675-9645
Practice Address - Street 1:1947 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3339
Practice Address - Country:US
Practice Address - Phone:716-675-9777
Practice Address - Fax:716-675-9645
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043247-11223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00020006801OtherUNIVERA HEALTHCARE
NY01241189Medicaid
NYC54853Medicare PIN
NYA54851Medicare PIN
NY14253DMedicare PIN
NY00020006801OtherUNIVERA HEALTHCARE