Joseph John Havrilla, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS024390L Issued in PA

Practice address

2004 Sproul Rd Ste 204
Broomall, PA 19008-3511

Phone

(610) 328-9608

Fax

(610) 328-5549

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Joseph J Havrilla DDS Inc

  • Periodontics
  • Broomall, PA
  • NPI 1639380033
  NPD Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1295954618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 SPROUL RD STE 204",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083511",
            "telephone_number": "610-328-9608",
            "fax_number": "610-328-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 SPROUL RD STE 204",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083511",
            "telephone_number": "610-328-9608",
            "fax_number": "610-328-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVRILLA",
        "first_name": "JOSEPH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS024390L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian G Hall, OT
• Leonard M Haltrecht, D.O.
• Courtney B Hammerel, MD
• Edward Haughey, PT
• Haverford Anesthesia Associates
• Shelbee Kay Haynie
• Catherine Heagy, CRNP
• Health Access Network
• Amanda Hearn, LPC
• Ella Hecht

• Periodontics in Broomall, PA
• Providers in Broomall, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.

Verify at the official NPI Registry.