Active NPI
Andrea Nicole Puddicombe, DMD
- Dentist
- Milford, DE
National Provider Identifier
1285800524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- G1-0001282
- Practice address
- 215 West Liberty Way
Milford, DE 19963 - Phone
- (302) 424-7976
- Fax
- (302) 424-2324
- NPI assigned
- May 6, 2008
- Last updated
- Aug 27, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | G3-0000351 | DE | |
| Dentist | 122300000X | G1-0001282 | DE | Primary |
Addresses
Primary practice location
215 West Liberty Way
Milford, DE 19963
Mailing address
215 West Liberty Way
Milford, DE 19963
Phone (302) 424-7976
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G3-0000351 | DE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diamond State Dentistry | Dentist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1285800524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 WEST LIBERTY WAY",
"city": "MILFORD",
"state": "DE",
"postal_code": "19963",
"telephone_number": "302-424-7976",
"fax_number": "302-424-2324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 WEST LIBERTY WAY",
"city": "MILFORD",
"state": "DE",
"postal_code": "19963",
"telephone_number": "302-424-7976",
"fax_number": "302-424-2324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUDDICOMBE",
"first_name": "ANDREA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-06",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "DE",
"license": "G3-0000351",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DE",
"license": "G1-0001282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.