Provider Demographics
NPI:1780264150
Name:PRESTIPINO, DOMINIC (DDS)
Entity type:Individual
Prefix:
First Name:DOMINIC
Middle Name:
Last Name:PRESTIPINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19643 BLUE BIRD LN UNIT 1
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6129
Mailing Address - Country:US
Mailing Address - Phone:302-226-7960
Mailing Address - Fax:
Practice Address - Street 1:19643 BLUE BIRD LN UNIT 1
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6129
Practice Address - Country:US
Practice Address - Phone:302-542-8632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-10
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00115191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice