=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245313204
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YONKERS DENTAL SURGERY P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 WARBURTON AVE
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-2720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-969-2227
-----------------------------------------------------
Fax | 914-969-2799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12 WARBURTON AVE
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10701-2720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-969-2227
-----------------------------------------------------
Fax | 914-969-2799
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. WILLIAM ALFONSO LIMONGELLI
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 347-865-2729
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------