Individual provider Active NPI

John C Dryden, DMD

  • Pediatric Dentistry
  • Lancaster, PA
National Provider Identifier
1437114253
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS037749 Issued in PA
Practice address
1685 Crown Ave
Lancaster, PA 17601-6322
Phone
(717) 295-4400
Fax
(717) 295-1389
NPI assigned
Apr 18, 2006
Last updated
Jul 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D5576 AZ
Pediatric Dentistry 1223P0221X DS037749 PA Primary
Pediatric Dentistry 1223P0221X S6-104C NV

Addresses

Primary practice location

1685 Crown Ave
Lancaster, PA 17601-6322

Mailing address

1685 Crown Ave
Lancaster, PA 17601-6322
Phone (717) 295-4400

Other identifiers 1

IdentifierTypeStateIssuer
645096MedicaidAZ

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

LicenseStateTypeSpecialty
D5576AZMDGeneral Practice Dentistry
S6-104CNVMDPediatric Dentist
DS037749PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Memorial Hospital Past Accepting new patients
Children's Dental Health Associates Pediatric Dentistry 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1437114253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 CROWN AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016322",
            "telephone_number": "717-295-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 CROWN AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016322",
            "telephone_number": "717-295-4400",
            "fax_number": "717-295-1389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYDEN",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5576",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS037749",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "S6-104C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "645096",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.