Jared Daniel Tuccillo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS044238 Issued in PA

Practice address

2370 York Rd Ste D1
Jamison, PA 18929-1031

Phone

(215) 343-3400

NPI assigned

Jul 11, 2023

Last updated

Jul 11, 2023By the provider in NPPES

Sex

Male

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1164101804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2091 FARMVIEW DR",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189409418",
            "telephone_number": "609-802-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 YORK RD STE D1",
            "city": "JAMISON",
            "state": "PA",
            "postal_code": "189291031",
            "telephone_number": "215-343-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2031 N Broad St Ste 141",
            "address_purpose": "LOCATION",
            "city": "Lansdale",
            "state": "PA",
            "postal_code": "194461063",
            "country_code": "US",
            "telephone_number": "215-393-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCCILLO",
        "first_name": "JARED",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Jamison, PA
• Providers in Jamison, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.