Jared J Pell, DDS – Dentist in Winchester, VA

Key facts

NPI: 1295946291
Entity type: Individual (NPI type 1)
Primary specialty: Dentist 122300000X
License: 0401410209 (VA)
Practice address: 1705 Amherst St Ste 102
Winchester, VA 22601-3346
Phone: (540) 667-8731
Fax: (540) 662-5072
NPI assigned: May 24, 2007
Sex: Male
Sole proprietor: Yes

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.

Jared J Pell DDS PC Dentist · Winchester, VA · NPI 1659724805

NPD (past) Authorized official DENTIST

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0401410209	VA	MD	Dentist

Practice roles

Organization	Specialty	Status	New patients
Jared J Pell DDS PC	Dentist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Dentist	122300000X	0401410209	VA	Yes

Addresses

Primary practice location

1705 Amherst St Ste 102
Winchester, VA 22601-3346

Mailing address

1705 Amherst St Ste 102
Winchester, VA 22601-3346
Phone (540) 667-8731

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 17, 2015.

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1295946291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 AMHERST ST STE 102",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013346",
            "telephone_number": "540-667-8731",
            "fax_number": "540-662-5072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 AMHERST ST STE 102",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226013346",
            "telephone_number": "540-667-8731",
            "fax_number": "540-662-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELL",
        "first_name": "JARED",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

All providers in Winchester, VA · Dentist in Virginia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.