Phoenix Dental Care, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PHOENIX DENTAL CARE, LLC

Practice address

475 Phoenix Dr
Chambersburg, PA 17201-4534

Phone

(717) 267-2059

NPI assigned

Jan 29, 2020

Last updated

Jan 29, 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

Jayne Keller, DMDNPI 1497838734

Title

Employee/Owner

Phone

(717) 267-2059

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.

• Jayne Keller, DMD

  • General Practice Dentistry
  • Chambersburg, PA
  • NPI 1497838734
  NPD Authorized official
• Kristen Willwerth, DDS

  • General Practice Dentistry
  • Chambersburg, PA
  • NPI 1083106165
  NPD (past)

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580256000000",
    "number": "1386275279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 PHOENIX DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014534",
            "telephone_number": "717-267-2059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PHOENIX DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014534",
            "telephone_number": "717-267-2059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_title_or_position": "EMPLOYEE/OWNER",
        "authorized_official_telephone_number": "717-267-2059",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Lynn Pett
• Natalie Petty, PA-C
• PGC Counseling, LLC
• Truc Thi Thu Pham, MD
• Janelle E Phillips
• Phoenix Rehabilitation and Health Services, Inc
• Phoenix Wellness and Physical Restoration Center, PLLC
• PHS Physical Therapy, LLC
• Erin Pickering
• Jada Pickett, OTR/L

• General Practice Dentistry in Chambersburg, PA
• Providers in Chambersburg, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.