Active NPI
Joseph Vincent Cellini, DMD
- Dentist
- South Bend, IN
National Provider Identifier
1578123360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12013214A
- Practice address
- 1005 E Lasalle Ave
South Bend, IN 46617-2818 - Phone
- (574) 367-7000
- NPI assigned
- Jun 14, 2019
- Sex
- Male
- 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 | 12013214A | IN | Primary |
| Dentist | 122300000X | 019.032070 | IL |
Addresses
Primary practice location
1005 E Lasalle Ave
South Bend, IN 46617-2818
Mailing address
14340 Jefferson Ave Apt 3S
Orland Park, IL 60462-5367
Phone (708) 372-8128
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 |
|---|---|---|---|
| 019.032070 | IL | MD | Dentist |
| 12013214A | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560988800000",
"number": "1578123360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14340 JEFFERSON AVE APT 3S",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604625367",
"telephone_number": "708-372-8128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 E LASALLE AVE",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466172818",
"telephone_number": "574-367-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELLINI",
"first_name": "JOSEPH",
"middle_name": "VINCENT",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-14",
"last_updated": "2019-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12013214A",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.032070",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
- Connor Cavanaugh, MD
- John J Cavanaugh, MD
- Christina Marie Cavinder, CPNP-PC
- CBS Transpro, Inc. (MedTransit Services)
- Lorraine Josephine Celis, D.D.S.
- Center for Eye-Care Excellence
- Center for Hospice and Palliative Care, Inc (Center for Adult Day Services, LLC)
- Center for Positive Change, Inc
- Center for Positive Change, Inc
- Center for Positive Change, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.