Anthony M Denicco, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS-015993L Issued in PA

Practice address

1630 E High St
BLDG 4
Pottstown, PA 19464-3244

Phone

(610) 326-7880

Fax

(610) 326-5491

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pottstown Oral & Maxillofacial Surgery Assoc. Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Pottstown, PA
  • NPI 1285638817
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215932181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 E HIGH ST",
            "address_2": "BLDG 4",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643244",
            "telephone_number": "610-326-7880",
            "fax_number": "610-326-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HIGH ST",
            "address_2": "BLDG 4",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643244",
            "telephone_number": "610-326-7880",
            "fax_number": "610-326-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICCO",
        "first_name": "ANTHONY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS-015993L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0048312000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CHOICE",
            "identifier": "0048312000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA COMMERCIAL PLANS",
            "identifier": "4100947",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03208501",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2422619",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "DE062812",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HEALTH PLAN EAST",
            "identifier": "0048312000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1177183-006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isibell Delrosario-Pucheu
• Joseph Stephen Demidovich III, D.O.
• Danielle Dempsey
• Kimberly Demyan
• Johnathon Lee Dengler
• August Andrew Denicco, D.D.S.
• Jaime Depaolo, MA
• Deborah A Depolo, M.A.
• Charlene Marie Deprophetis I
• Alivia Derr

• Oral and Maxillofacial Surgery (Dentist) in Pottstown, PA
• Providers in Pottstown, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.