Jay Bharat Tahiliani

Key facts

NPI

1740915966

Entity type

Individual (NPI type 1)

Primary specialty

Dentist 122300000X

License

DS043843 (PA)

Practice address

1051 E Main St Ste 4
Waynesboro, PA 17268-2318

Phone

(717) 762-6699

NPI assigned

Jul 21, 2022

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• Heartland Dental Care of Pennslyvania General Practice Dentistry · Waynesboro, PA · NPI 1346596210
  NPD (past)
• Logan Meals LLC General Practice Dentistry · Waynesboro, PA · NPI 1790793057
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 10, 2022.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1740915966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 E MAIN ST STE 4",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172682318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 E MAIN ST STE 4",
            "city": "WAYNESBORO",
            "state": "PA",
            "postal_code": "172682318",
            "telephone_number": "717-762-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHILIANI",
        "first_name": "JAY",
        "middle_name": "BHARAT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaytahiliani80@mydentalmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1051 E Main St Ste 4",
            "city": "Waynesboro",
            "state": "PA",
            "country_code": "US",
            "postal_code": "172682318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Bridget Marie Stull, CNA GNA
• Connie Lorraine Suffecool, PTA
• Jana Lynn Swartz-Gillitzer, M.S.
• Matthew Tapper, MS, LMFT
• Robert J Ternes, M.D.
• Timothy Robert Test Sr., PHD
• The Chiropractic Edge
• Theodore H. Cryer, M.D., F.a.C.S.

All providers in Waynesboro, PA · Dentist in Pennsylvania