Andrea Nicole Puddicombe, DMD
Individual provider Active NPI Dentist · Milford, DE
NPI 1285800524 · NPPES record last updated Aug 27, 2013
Key facts
- NPI
- 1285800524
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- G1-0001282 (DE)
- Practice address
- 215 West Liberty Way
Milford, DE 19963 - Phone
- (302) 424-7976
- Fax
- (302) 424-2324
- NPI assigned
- May 6, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1-0001282 | DE | MD | Dentist |
| G3-0000351 | DE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diamond State Dentistry | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | G3-0000351 | DE | |
| Dentist | 122300000X | G1-0001282 | DE | Yes |
Addresses
Primary practice location
215 West Liberty Way
Milford, DE 19963
Mailing address
215 West Liberty Way
Milford, DE 19963
Phone (302) 424-7976
Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.