Individual provider Active NPI

Jeffrey Puglese, D.D.S.

  • Dentist
  • York, PA
National Provider Identifier
1205937950
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS022376L Issued in PA
Practice address
1447 E Market St
York, PA 17403-1254
Phone
(717) 845-2771
Fax
(717) 845-5907
NPI assigned
Sep 26, 2006
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS022376L PA Primary

Addresses

Primary practice location

1447 E Market St
York, PA 17403-1254

Mailing address

1447 E Market St
York, PA 17403-1254
Phone (717) 845-2771

Other identifiers 1

IdentifierTypeStateIssuer
134841OtherPAUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150706000176 PA Order and Referring Only - DentistPractitioner - Dentist 2163672437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS022376LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
1447 Dental Associates Dentist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jpuglese162469@wellspan.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1205937950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174031254",
            "telephone_number": "717-845-2771",
            "fax_number": "717-845-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 E MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174031254",
            "telephone_number": "717-845-2771",
            "fax_number": "717-845-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGLESE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS022376L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "134841",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.