Individual provider Active NPI

John Battista Fontana III, D.M.D.

  • Dentist
  • Dover, DE
National Provider Identifier
1336418151
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G1-0001312 Issued in DE
Practice address
910 Walker Rd Ste a
Dover, DE 19904-2759
Phone
(302) 734-1950
Fax
(302) 734-4097
NPI assigned
Dec 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14567 MD
Dentist 122300000X G1-0001312 DE Primary

Addresses

Primary practice location

910 Walker Rd Ste a
Dover, DE 19904-2759

Mailing address

910 Walker Rd Ste a
Dover, DE 19904-2759
Phone (302) 734-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20150706000101 DE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9931411907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G1-0001312DEMDDentist
14567MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven D Nemcic DDS Ms PA Past Accepting new patients
John B, Fontana, III, DMD, Ms, LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1336418151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WALKER RD STE A",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042759",
            "telephone_number": "302-734-1950",
            "fax_number": "302-734-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WALKER RD STE A",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042759",
            "telephone_number": "302-734-1950",
            "fax_number": "302-734-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTANA",
        "first_name": "JOHN",
        "middle_name": "BATTISTA",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14567",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.