MEDICARE: DOMINIC PRESTIPINO DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	G1-0011519	DE

General Provider Information

NPI Number	:	1780264150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIC PRESTIPINO DDS

Provider Business Mailing Address
First Line	:	19643 BLUE BIRD LN UNIT 1
Second Line	:
City	:	REHOBOTH BEACH
State	:	DE
Zip	:	19971-6129
Country	:	US
Telephone Number	:	302-226-7960
Fax Number	:

Provider Business Practice Location Address
First Line	:	19643 BLUE BIRD LN UNIT 1
Second Line	:
City	:	REHOBOTH BEACH
State	:	DE
Zip	:	19971-6129
Country	:	US
Telephone Number	:	302-542-8632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2021
Last Update Date	:	08/19/2025

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