Active NPI
Jenette D Intrachat, DDS
- Dentist
- King of Prussia, PA
National Provider Identifier
1386827202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00011067
- Practice address
- 357 S Gulph Rd
Suite 100
King of Prussia, PA 19406-3136 - Phone
- (610) 337-2325
- Fax
- (610) 337-2325
- NPI assigned
- Dec 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00011067 | WA | Primary |
Addresses
Primary practice location
357 S Gulph Rd
Suite 100
King of Prussia, PA 19406-3136
Mailing address
357 S Gulph Rd
Suite 100
King of Prussia, PA 19406-3136
Phone (610) 337-2325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE00011067 | Other | WA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00011067 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Merion Dental Associates P C | Past | Accepting new patients | |
| Upper Merion Periodontal Associates | 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.
-
- Dental Clinic/Center
- King of Prussia, PA
- NPI 1235296831
-
- Periodontics
- King of Prussia, PA
- NPI 1831317254
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1386827202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 S GULPH RD",
"address_2": "SUITE 100",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194063136",
"telephone_number": "610-337-2325",
"fax_number": "610-337-3863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "357 S GULPH RD",
"address_2": "SUITE 100",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194063136",
"telephone_number": "610-337-2325",
"fax_number": "610-337-2325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INTRACHAT",
"first_name": "JENETTE",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-13",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00011067",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "DE00011067",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.