Individual provider Active NPI

Anthony D Kuprionas, DDS

  • Pediatric Dentistry
  • Pittston, PA
National Provider Identifier
1275685315
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS019157L Issued in PA
Practice address
1073 Oak St
Pittston, PA 18640-3716
Phone
(570) 654-4141
Fax
(570) 654-2150
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS019157L PA Primary

Addresses

Primary practice location

1073 Oak St
Pittston, PA 18640-3716

Mailing address

1073 Oak St
Pittston, PA 18640-3716
Phone (570) 654-4141

Other identifiers 1

IdentifierTypeStateIssuer
0005246090002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS019157LPAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Casey Dental Institute P.C. PastSince Aug 14, 2019 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1275685315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 OAK ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186403716",
            "telephone_number": "570-654-4141",
            "fax_number": "570-654-2150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 OAK ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186403716",
            "telephone_number": "570-654-4141",
            "fax_number": "570-654-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPRIONAS",
        "first_name": "ANTHONY",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS019157L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005246090002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.