Individual provider Active NPI

Ryan Carl Dell'Aglio, D.M.D

  • Dentist
  • Scranton, PA
National Provider Identifier
1699110775
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039531 Issued in PA
Practice address
959 Wyoming Ave
Scranton Primary Health Center
Scranton, PA 18509-3023
Phone
(570) 504-0882
Fax
(570) 504-0859
NPI assigned
May 2, 2013
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2013018051 MO
Dentist 122300000X DS039531 PA Primary

Addresses

Primary practice location

959 Wyoming Ave
Scranton Primary Health Center
Scranton, PA 18509-3023

Mailing address

959 Wyoming Ave
Scranton Primary Health Care Center, Inc.
Scranton, PA 18509-3023
Phone (570) 504-0882

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170608000342 PA Practitioner - Oral Surgery 0941503627 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scranton Primary Health Care Center, Inc. CurrentSince Feb 8, 2017 Accepting new patients
Scranton Primary Health Care Center, Inc. Current Accepting new patients
Scranton Primary Health Care Center, Inc CurrentSince Feb 8, 2017 Accepting new patients

Locations

959 Wyoming Ave
Scranton, PA 18509
Phone (570) 344-3517

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1699110775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 WYOMING AVE",
            "address_2": "SCRANTON PRIMARY HEALTH CARE CENTER, INC.",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185093023",
            "telephone_number": "570-504-0882",
            "fax_number": "570-504-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 WYOMING AVE",
            "address_2": "SCRANTON PRIMARY HEALTH CENTER",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185093023",
            "telephone_number": "570-504-0882",
            "fax_number": "570-504-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELL'AGLIO",
        "first_name": "RYAN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-02",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2013018051",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

Verify at the official NPI Registry.