Active NPI
Judith Elaine McCann, DMD
- Dentist
- Newark, DE
National Provider Identifier
1801945191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- GI0000933
- Practice address
- 625 Barksdale Rd
101 Barksdale Professional Center
Newark, DE 19711-4535 - Phone
- (302) 368-7463
- Fax
- (302) 368-2520
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- 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 | GI0000933 | DE | Primary |
Addresses
Primary practice location
625 Barksdale Rd
101 Barksdale Professional Center
Newark, DE 19711-4535
Mailing address
625 Barksdale Rd
101 Barksdale Professional Center
Newark, DE 19711-4535
Phone (302) 368-7463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000015397 | Medicaid | DE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GI0000933 | DE | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801945191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 BARKSDALE RD",
"address_2": "101 BARKSDALE PROFESSIONAL CENTER",
"city": "NEWARK",
"state": "DE",
"postal_code": "197114535",
"telephone_number": "302-368-7463",
"fax_number": "302-368-2520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 BARKSDALE RD",
"address_2": "101 BARKSDALE PROFESSIONAL CENTER",
"city": "NEWARK",
"state": "DE",
"postal_code": "197114535",
"telephone_number": "302-368-7463",
"fax_number": "302-368-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCANN",
"first_name": "JUDITH",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "DE",
"license": "GI0000933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000015397",
"state": "DE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.