Individual provider Active NPI

Robert Martin Paolino, DMD

  • Dentist
  • Glen Mills, PA
National Provider Identifier
1417036914
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS0235264 Issued in PA
Practice address
871 Baltimore Pike
Suite 15
Glen Mills, PA 19342
Phone
(610) 459-4179
Fax
(610) 459-9242
NPI assigned
Nov 3, 2006
Last updated
Jun 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS0235264 PA Primary

Addresses

Primary practice location

871 Baltimore Pike
Suite 15
Glen Mills, PA 19342

Mailing address

871 Baltimore Pike
Suite 15
Glen Mills, PA 19342
Phone (610) 459-4179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120322000666 PA Practitioner - Oral Surgery 6305006669 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Mills, PA

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 Regency PLZ
Glen Mills, PA 19342-1000
Phone (610) 459-4179

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS0235264PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Oralfacial Dental Implant Surgery Center PastSince Feb 15, 2012 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

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.

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1417036914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 BALTIMORE PIKE",
            "address_2": "SUITE 15",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "19342",
            "telephone_number": "610-459-4179",
            "fax_number": "610-459-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 BALTIMORE PIKE",
            "address_2": "SUITE 15",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "19342",
            "telephone_number": "610-459-4179",
            "fax_number": "610-459-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAOLINO",
        "first_name": "ROBERT",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS0235264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

Verify at the official NPI Registry.