NPIMap

Individual provider Active NPI

Jonathan Michael Tagliareni, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Danville, PA
National Provider Identifier
1700182482
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS045057 Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-2769
Phone
(570) 271-6355
Fax
(570) 271-5788
NPI assigned
Jan 28, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS045057 PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-2769

Mailing address

100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6355

Other identifiers 1

IdentifierTypeStateIssuer
ZX9479MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathan.tagliareni@mpaii.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250806003522 PA Practitioner - Oral Surgery 4284985037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6211

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jul 14, 2025 Accepting new patients
Geisinger Clinic Oral and Maxillofacial Surgery CurrentSince Jul 14, 2025 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

Interoperability endpoints

  • Direct secure messaging: jtagliareni19362@directmcleodehealth.org
  • Direct secure messaging: jonathan.tagliareni@mpaii.eclinicaldirectplus.com
  • Direct secure messaging: jtagliareni96602@direct.geisinger.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1700182482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6355",
            "fax_number": "570-271-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222769",
            "telephone_number": "570-271-6355",
            "fax_number": "570-271-5788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGLIARENI",
        "first_name": "JONATHAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-28",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS045057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX9479",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.tagliareni@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "101 William H Johnson St Ste 440",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295062769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.