Active NPI
Alyssa Southard, DMD
- Dentist
- Jenkintown, PA
National Provider Identifier
1497216055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS042469
- Practice address
- 1250 Greenwood Ave Ste 10
Jenkintown, PA 19046-2900 - Phone
- (215) 887-4004
- NPI assigned
- Mar 27, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS042469 | PA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1250 Greenwood Ave Ste 10
Jenkintown, PA 19046-2900
Mailing address
1283 Lincoln Highway
Levittown, PA 19056
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 |
|---|---|---|---|
| DS042469 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771977600000",
"number": "1497216055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1283 LINCOLN HIGHWAY",
"city": "LEVITTOWN",
"state": "PA",
"postal_code": "19056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 GREENWOOD AVE STE 10",
"city": "JENKINTOWN",
"state": "PA",
"postal_code": "190462900",
"telephone_number": "215-887-4004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTHARD",
"first_name": "ALYSSA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-27",
"last_updated": "2026-02-25",
"certification_date": "2026-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS042469",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenkintown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.