Jude M Gaydos, DMD
Individual provider Active NPI General Practice Dentistry · Schuylkill Haven, PA
NPI 1407059918 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407059918
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 05028647L (PA)
- Practice address
- 111 Lilly Street
Schuylkill Haven, PA 17972 - Phone
- (570) 385-9001
- Fax
- (570) 385-1190
- NPI assigned
- Jun 11, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05028647L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edward J Gaydos DPM PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 05028647L | PA | Yes |
Addresses
Primary practice location
111 Lilly Street
Schuylkill Haven, PA 17972
Mailing address
111 Lilly Street
Schuylkill Haven, PA 17972
Phone (570) 385-9001
Other providers in Schuylkill Haven, PA
- Jeffrey Scott Faust
- Elizabeth Santos Fisher
- Francis G. a. Solga,DDS, PC
- Carroll S. Freestone
- Edward J Gaydos
- Teresa Ann Gaydos
- Genesis Healthcare
- Genesis Rehab Services
- George L. Roberts
- Carol Ann Giacovelli
All providers in Schuylkill Haven, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.