Individual provider Active NPI

Jacqueline Caster

  • Pediatric Dentistry
  • Lebanon, PA
National Provider Identifier
1033596812
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
042095 Issued in PA
Practice address
860 Tuck St Ste 200
Lebanon, PA 17042-7477
Phone
(717) 892-5193
NPI assigned
Apr 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019.030315 IL
Pediatric Dentistry 1223P0221X 64674 CA
Pediatric Dentistry 1223P0221X 042095 PA Primary

Addresses

Primary practice location

860 Tuck St Ste 200
Lebanon, PA 17042-7477

Mailing address

860 Tuck St Ste 200
Lebanon, PA 17042-7477
Phone (717) 892-5193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160205001650 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800190166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042095PAMDPediatric Dentist
64674CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Verber Dental Group, PC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1033596812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 TUCK ST STE 200",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427477",
            "telephone_number": "717-892-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 TUCK ST STE 200",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427477",
            "telephone_number": "717-892-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTER",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-30",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019.030315",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "64674",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "042095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.