Individual provider Active NPI

John J Ciabattoni, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Wyomissing, PA
National Provider Identifier
1154300028
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS017990L Issued in PA
Practice address
1075 Berkshire Blvd
Ste 800
Wyomissing, PA 19610
Phone
(610) 374-4093
Fax
(610) 375-6454
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS017990L PA Primary

Addresses

Primary practice location

1075 Berkshire Blvd
Ste 800
Wyomissing, PA 19610

Mailing address

1075 Berkshire Blvd
Ste 800
Wyomissing, PA 19610
Phone (610) 374-4093

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wyomissing Oral Surgical Assocs, LTD Oral and Maxillofacial Surgery Past Accepting new patients
Berks Oral Surgery, PLLC Oral and Maxillofacial Surgery 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1154300028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "STE 800",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "19610",
            "telephone_number": "610-374-4093",
            "fax_number": "610-375-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 BERKSHIRE BLVD",
            "address_2": "STE 800",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "19610",
            "telephone_number": "610-374-4093",
            "fax_number": "610-375-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIABATTONI",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS017990L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.