Individual provider Active NPI

Kevin T Fabbri, D.M.D

  • Dentist
  • Manchester, PA
National Provider Identifier
1073644662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS027294L Issued in PA
Practice address
222 Rosedale Dr
Manchester, PA 17345-1023
Phone
(717) 266-3601
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS027294L PA Primary

Addresses

Primary practice location

222 Rosedale Dr
Manchester, PA 17345-1023

Mailing address

700 Applewine CT
York, PA 17404-6466
Phone (717) 757-6209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170124000320 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133428386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS027294LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Dental Inc. Past Accepting new patients
Wheatlyn Dental Practice, LLP Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073644662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 APPLEWINE CT",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174046466",
            "telephone_number": "717-757-6209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 ROSEDALE DR",
            "city": "MANCHESTER",
            "state": "PA",
            "postal_code": "173451023",
            "telephone_number": "717-266-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABBRI",
        "first_name": "KEVIN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027294L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, PA

Sources for this page

Verify at the official NPI Registry.