Richard C Squillaro, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS017459L Issued in PA

Practice address

2546 S Broad St
Philadelphia, PA 19145-4638

Phone

(215) 463-6677

Fax

(215) 463-1077

NPI assigned

May 14, 2013

Last updated

May 14, 2013By 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

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.

• Richard C Squillaro D.D.S., PC

  • Periodontics
  • Philadelphia, PA
  • NPI 1932323235
  Authorized official Same address or phone

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1194161455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454638",
            "telephone_number": "215-463-6677",
            "fax_number": "215-463-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454638",
            "telephone_number": "215-463-6677",
            "fax_number": "215-463-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUILLARO",
        "first_name": "RICHARD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS017459L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacquelyn Patrice Squares, CRNP
• Squeezren, LLC
• Danielle Christine Squilla, MSN, CRNA
• Gabrielle Squilla
• Michael Squillace, RN, CRNA
• Abby Squire, MSW, LCSW
• Kathleen E. Squires, M.D.
• Siva Sreedhar
• Raman R Sreedharan, M.D.
• Krishnalatha Sreekrishnanilayam Devakliamma, MD

• Periodontics in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.