Jessica Marie Cicone, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

33959 Issued in TX

Practice address

1455 E Whitestone Blvd Ste 127
Cedar Park, TX 78613

Phone

(512) 259-7171

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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.

• Cedar Park Modern Dentistry, PC

  • General Practice Dentistry
  • Cedar Park, TX
  • NPI 1205144920
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1285068239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 E WHITESTONE BLVD STE 127",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 E WHITESTONE BLVD STE 127",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "78613",
            "telephone_number": "512-259-7171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Child St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322145005",
            "country_code": "US",
            "telephone_number": "912-573-4212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICONE",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62635",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "62635",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "33959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Chu
• Nick Chu, O.D.
• Sophie Chudleigh, LCSW
• Daija Chumley
• Satish Chundru, DO
• Gloria Circosta, RN, IBCLC
• City of Cedar Park
• City of Cedar Park Fire Department
• CK Dental Group
• Clarity Brain and Spine, PA

• Dentist in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.