Peter M Famiglio, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS026077L Issued in PA

Practice address

25 Dowlin Forge Rd
Exton, PA 19341-1548

Phone

(610) 363-7000

Fax

(610) 363-7687

NPI assigned

Mar 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Brandywine Dental Implants and Oral & Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Exton, PA
  • NPI 1376761551
  NPD (past) Authorized official

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1316908478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 DOWLIN FORGE RD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411548",
            "telephone_number": "610-363-7000",
            "fax_number": "610-363-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 DOWLIN FORGE RD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193411548",
            "telephone_number": "610-363-7000",
            "fax_number": "610-363-7687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Reeceville Rd Ste 11",
            "address_purpose": "LOCATION",
            "city": "Coatesville",
            "state": "PA",
            "postal_code": "193201532",
            "country_code": "US",
            "telephone_number": "610-363-7000",
            "fax_number": "610-363-7687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAMIGLIO",
        "first_name": "PETER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS026077L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL #",
            "identifier": "000525541",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PRACTICE HMO #",
            "identifier": "0227912000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP #",
            "identifier": "000159506",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INDIVIDUAL HMO#",
            "identifier": "0113323000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Exton, PA
• Providers in Exton, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.