Individual provider Active NPI

Joseph John Paradine, DDS

  • General Practice Dentistry
  • Media, PA
National Provider Identifier
1083961056
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS015204L Issued in PA
Practice address
350 S. Providence Rd
Media, PA 19063
Phone
(610) 566-3326
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS015204L PA Primary

Addresses

Primary practice location

350 S. Providence Rd
Media, PA 19063

Mailing address

350 S. Providence Rd
Media, PA 19063
Phone (610) 566-3326

Other identifiers 2

IdentifierTypeStateIssuer
DS015204LOtherPADENTAL LICENSE
114621172OtherPAADA #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS015204LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1083961056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S. PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-566-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S. PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-566-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADINE",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS015204L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DS015204L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADA #",
            "identifier": "114621172",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.