Individual provider Active NPI

John Palm, D.D.S.

  • General Practice Dentistry
  • Chambersburg, PA
National Provider Identifier
1255375242
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS028866L Issued in PA
Practice address
767 5TH Ave Ste B3-a
Chambersburg, PA 17201-4207
Phone
(717) 709-7940
Fax
(717) 263-8014
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS028866L PA Primary

Addresses

Primary practice location

767 5TH Ave Ste B3-a
Chambersburg, PA 17201-4207

Mailing address

111 Chambers Hill Dr Ste 200
Chambersburg, PA 17201-7304
Phone (717) 709-7922

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225001441 PA Order and Referring Only - DentistPractitioner - Dentist 7214232479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1255375242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHAMBERS HILL DR STE 200",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172017304",
            "telephone_number": "717-709-7922",
            "fax_number": "717-263-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 5TH AVE STE B3-A",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014207",
            "telephone_number": "717-709-7940",
            "fax_number": "717-263-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALM",
        "first_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS028866L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.