Provider Demographics
NPI:1881571172
Name:PRESTIPINODDS, LLC
Entity type:Organization
Organization Name:PRESTIPINODDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTIPINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-542-8632
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:302-226-7960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-19
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty