NPIMap

Organization Active NPI

Aqueline Elizabeth Kirby Memorial Health Center Dental Clinic

  • General Practice Dentistry
  • Wilkes Barre, PA
National Provider Identifier
1225254634
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AQUELINE ELIZABETH KIRBY MEMORIAL HEALTH CENTER DENTAL CLINIC
Practice address
71 N Franklin St
Wilkes Barre, PA 18701-1312
Phone
(570) 822-4278
Fax
(570) 825-9926
NPI assigned
Apr 17, 2007
Last updated
Apr 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Ms. Danielle Cappellini
Title
Executive Director
Phone
(570) 822-4178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

71 N Franklin St
Wilkes Barre, PA 18701-1312

Mailing address

71 N Franklin St
Wilkes Barre, PA 18701-1312
Phone (570) 822-4278

Other identifiers 3

IdentifierTypeStateIssuer
167782OtherPAUNISON
828141OtherPWGATEWAY
0007139380002OtherPAMEDICAL ASSISTANCE

National Provider Directory

National Provider Directory
Tax ID family
Angeline Elizabeth Kirby Memorial Health Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1225254634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 N FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187011312",
            "telephone_number": "570-822-4278",
            "fax_number": "570-825-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 N FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187011312",
            "telephone_number": "570-822-4278",
            "fax_number": "570-825-9926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUELINE ELIZABETH KIRBY MEMORIAL HEALTH CENTER DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "CAPPELLINI",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "570-822-4178",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "167782",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "828141",
            "state": "PW"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "0007139380002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.