Elizabeth Puddu, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS041892 Issued in PA

Practice address

1932 W Market St
Pottsville, PA 17901-2004

Phone

(570) 622-2727

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1033697396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 MAHANTONGO ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013303",
            "telephone_number": "570-573-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 W MARKET ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012004",
            "telephone_number": "570-622-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Tamaqua",
            "state": "PA",
            "postal_code": "182522009",
            "country_code": "US",
            "telephone_number": "570-668-6837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUDDU",
        "first_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.