Individual provider Active NPI

Jessica Dileo, DMD

  • Dentist
  • Murfreesboro, TN
National Provider Identifier
1821535790
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10414 Issued in TN
Practice address
125 Wendelwood Dr Ste B
Murfreesboro, TN 37129-3746
Phone
(615) 904-1585
Fax
(615) 913-4184
NPI assigned
Jan 30, 2017
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10414 TN Primary

Addresses

Primary practice location

125 Wendelwood Dr Ste B
Murfreesboro, TN 37129-3746

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20170228001454 TN Order and Referring Only - DentistPractitioner - Dentist 0042594590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10414TNMDPhysical Therapist
37237TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Murfreesboro Smiles Dentistry, PC Dentist Past Accepting new patients

Organizations & group practices 1

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": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1821535790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WENDELWOOD DR STE B",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293746",
            "telephone_number": "615-904-1585",
            "fax_number": "615-913-4184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILEO",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.