James Clemens Definnis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS-031113-L Issued in PA

Practice address

210 Carverton Rd
Trucksville, PA 18708-1745

Phone

(570) 696-1105

NPI assigned

Feb 16, 2015

Last updated

Feb 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 PA

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.

• Back Mountain Dental, Inc.

  • General Practice Dentistry
  • Trucksville, PA
  • NPI 1245301381
  NPD (past) Authorized official

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1578954228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CARVERTON RD",
            "city": "TRUCKSVILLE",
            "state": "PA",
            "postal_code": "187081745",
            "telephone_number": "570-696-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 CARVERTON RD",
            "city": "TRUCKSVILLE",
            "state": "PA",
            "postal_code": "187081745",
            "telephone_number": "570-696-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFINNIS",
        "first_name": "JAMES",
        "middle_name": "CLEMENS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-16",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS-031113-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kati Autolitano
• Back Mountain Dental, Inc.
• Back Mountain Neurodiagnostics, PC
• Chiropractic and Rehab Associates of Dallas, PC
• Brandon Michael Jayne, MSPT
• Angela Lynn
• Mark Evan Morris, D.C.
• Jordan Simon, DMD
• Trucksville Pharmacy LLC (Trucksville Pharmacy)

• Dentist in Trucksville, PA
• Providers in Trucksville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2015; 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.