Jeffrey S Panicucci, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI18055 Issued in NJ

Practice address

1 Professional Quad
Sparta, NJ 07871-2330

Phone

(973) 729-7100

Fax

(973) 729-0671

NPI assigned

May 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• DRS. Panicucci and Ouimette, L.L.C.

  • General Practice Dentistry
  • Sparta, NJ
  • NPI 1265644579
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568675106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL QUAD",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712330",
            "telephone_number": "973-729-7100",
            "fax_number": "973-729-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL QUAD",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078712330",
            "telephone_number": "973-729-7100",
            "fax_number": "973-729-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANICUCCI",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI18055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Silvana Pagnacco, BCBA
• Pain Physicians NJ LLC
• Carlos A Palacios-Avila
• Patricia Starr Palko
• Rachel Sadie Palmer, MA, LAC
• Anthony Jordan Papadopoulos, MD
• Fiorella Paradisi
• Teesha Parikh
• George T Parker, DMD
• Kelly M Parker, FNP-BC

• General Practice Dentistry in Sparta, NJ
• Providers in Sparta, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.

Verify at the official NPI Registry.