Active NPI
Justin Josell, D.D.S.
- Pediatric Dentistry
- Smyrna, DE
National Provider Identifier
1508211715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- G1-0001404
- Practice address
- 51 Huntfield Dr Ste 100
Smyrna, DE 19977-2973 - Phone
- (302) 508-0037
- NPI assigned
- Apr 26, 2016
- Last updated
- Aug 3, 2024
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | G1-0001404 | DE | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | 0442000378 | VA |
Addresses
Primary practice location
51 Huntfield Dr Ste 100
Smyrna, DE 19977-2973
Mailing address
1713 W 13TH St
Wilmington, DE 19806-4009
Phone (443) 812-5562
Other practice location 1
521 N 11th St
Richmond, VA 23298-5016
Phone (804) 827-1244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- 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 |
|---|---|---|---|---|
| I20160705000538 | MS | Order and Referring Only - Oral Surgery | 1658663125 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G1-0001404 | DE | MD | Pediatric Dentist |
| 0442000378 | VA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Little Tooth Doctors LLC | Pediatric Dentistry | Current | Accepting new patients |
Locations
51 Huntfield Dr
Ste 100
Smyrna, DE 19977
Phone (302) 508-0037
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.
-
dba Smyrna Pediatric Dentistry
- Pediatric Dentistry
- Smyrna, DE
- NPI 1669107009
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722643200000",
"number": "1508211715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1713 W 13TH ST",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198064009",
"telephone_number": "443-812-5562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 HUNTFIELD DR STE 100",
"city": "SMYRNA",
"state": "DE",
"postal_code": "199772973",
"telephone_number": "302-508-0037"
}
],
"practiceLocations": [
{
"address_1": "521 N 11th St",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232985016",
"country_code": "US",
"telephone_number": "804-827-1244",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOSELL",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-26",
"last_updated": "2024-08-03",
"certification_date": "2024-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "DE",
"license": "G1-0001404",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VA",
"license": "0442000378",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Smyrna, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.