Active NPI
J. Ward Fitzpatrick, D.D.S.
- Periodontics
- Kingston, PA
National Provider Identifier
1467661850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS026620L
- Practice address
- 550 3Rd Ave
Suite 3
Kingston, PA 18704-5806 - Phone
- (570) 283-3300
- Fax
- (570) 331-7129
- NPI assigned
- May 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS026620L | PA | Primary |
Addresses
Primary practice location
550 3Rd Ave
Suite 3
Kingston, PA 18704-5806
Mailing address
550 3Rd Ave
Suite 3
Kingston, PA 18704-5806
Phone (570) 283-3300
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 |
|---|---|---|---|
| DS026620L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467661850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 3RD AVE",
"address_2": "SUITE 3",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187045806",
"telephone_number": "570-283-3300",
"fax_number": "570-331-7129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 3RD AVE",
"address_2": "SUITE 3",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187045806",
"telephone_number": "570-283-3300",
"fax_number": "570-331-7129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZPATRICK",
"first_name": "J.",
"middle_name": "WARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS026620L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, PA
- Timothy John Figueroa
- Molly Rose Finkbiner, MT-BC
- First Hospital Psy Operations LLC (Wyoming Valley Behavioral Health)
- First Hospital Psy Operations LLC (Wyoming Valley Behavioral Hospital)
- Richard E Fischbein, MD
- Bridget Fitzsimmons
- Thomas Joseph Fiume, M.D.
- Five Star Quality Care-GHV, LLC (Tiffany Court at Kingston)
- Amy Louise Flaherty, PA-C
- Gilbert Jay Fleischman, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.