Individual provider Active NPI

Allison Carrie Sceppaguercio, D.M.D.

  • Dentist
  • Clark, NJ
National Provider Identifier
1164817284
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02618300 Issued in NJ
Practice address
152 Central Ave
#202
Clark, NJ 07066-1115
Phone
(732) 382-8280
NPI assigned
Apr 6, 2015
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02618300 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X 0 NU

Addresses

Primary practice location

152 Central Ave
#202
Clark, NJ 07066-1115

Mailing address

152 Central Ave
#202
Clark, NJ 07066-1115
Phone (732) 382-8280

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
22DI02618300NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1164817284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 CENTRAL AVE",
            "address_2": "#202",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661115",
            "telephone_number": "732-382-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 CENTRAL AVE",
            "address_2": "#202",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661115",
            "telephone_number": "732-382-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCEPPAGUERCIO",
        "first_name": "ALLISON",
        "middle_name": "CARRIE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02618300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": "0",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; 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.