Active NPI
Jason A Phillips, D.D.S.
- Dentist
- Lancaster, PA
National Provider Identifier
1649577248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS027956L
- Practice address
- 230 Harrisburg Ave.
Lancaster, PA 17603 - Phone
- (717) 293-2784
- Fax
- (717) 293-2793
- NPI assigned
- Feb 16, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS027956L | PA | Primary |
Addresses
Primary practice location
230 Harrisburg Ave.
Lancaster, PA 17603
Mailing address
230 Harrisburg Ave.
Lancaster, PA 17603
Phone (717) 293-2784
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150616001827 | PA | Order and Referring Only - Dentist | 3375854482 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS027956L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297814400000",
"number": "1649577248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 HARRISBURG AVE.",
"city": "LANCASTER",
"state": "PA",
"postal_code": "17603",
"telephone_number": "717-293-2784",
"fax_number": "717-293-2793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 HARRISBURG AVE.",
"city": "LANCASTER",
"state": "PA",
"postal_code": "17603",
"telephone_number": "717-293-2784",
"fax_number": "717-293-2793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JASON",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-02-16",
"last_updated": "2011-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS027956L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.