Pelly Dental Inc PC

Primary specialty

DentistTaxonomy code 122300000X

License

DS017449L Issued in PA

Legal business name

PELLY DENTAL INC PC

Practice address

20 E Broad St
West Hazleton, PA 18202

Phone

(570) 455-8800

NPI assigned

Aug 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph S Pelly, DDSNPI 1952478349

Title

Dentist

Phone

(570) 455-8800

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph Serafin Pelly, DDS

  • Dentist
  • West Hazelton, PA
  • NPI 1952478349
  NPD (past) Authorized official
• Teresa Maria Pelly, DMD

  • Dentist
  • West Hazleton, PA
  • NPI 1386759900
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376554790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E BROAD ST",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-455-8800",
            "fax_number": "570-455-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E BROAD ST",
            "city": "WEST HAZLETON",
            "state": "PA",
            "postal_code": "18202",
            "telephone_number": "570-455-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLY DENTAL INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PELLY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "570-455-8800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS017449L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Counseling Service
• Northeast Counseling Services
• Kristen Lynn Nowak, PTA
• Amanda Catherine Odonnell
• William Mark Pavlick, DDS
• Teresa Maria Pelly, DMD
• Mary Ann Elizabeth Rother, OTR/L
• Jillian Marie Roush, PA-C
• Yamunadevi Sadasivan, M.D
• Amanda Sember

• Dentist in West Hazleton, PA
• Providers in West Hazleton, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.