Active NPI
Anne Joucla Dufour
- Periodontics
- Douglassville, PA
National Provider Identifier
1487734141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS028998L
- Practice address
- 1050 Ben Franklin Hwy W
Douglassville, PA 19518-1042 - Phone
- (610) 385-1178
- Fax
- (610) 779-6162
- NPI assigned
- Oct 17, 2006
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DS028998L | PA | Primary |
Addresses
Primary practice location
1050 Ben Franklin Hwy W
Douglassville, PA 19518-1042
Mailing address
3528 Saint Lawrence Ave
Reading, PA 19606-2325
Phone (610) 779-2222
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150417000663 | PA | Order and Referring Only - Dentist | 1254659568 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS028998L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487734141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3528 SAINT LAWRENCE AVE",
"city": "READING",
"state": "PA",
"postal_code": "196062325",
"telephone_number": "610-779-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 BEN FRANKLIN HWY W",
"city": "DOUGLASSVILLE",
"state": "PA",
"postal_code": "195181042",
"telephone_number": "610-385-1178",
"fax_number": "610-779-6162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFOUR",
"first_name": "ANNE",
"middle_name": "JOUCLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS028998L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglassville, PA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.