Individual provider Active NPI

Joanie Jean

  • Pediatric Dentistry
  • Philadelphia, PA
National Provider Identifier
1831650233
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS043908 Issued in PA
Practice address
240 S 40TH St
Philadelphia, PA 19104-6030
Phone
(215) 898-7337
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI02847400 NJ
Pediatric Dentistry 1223P0221X DS043908 PA Primary

Addresses

Primary practice location

240 S 40TH St
Philadelphia, PA 19104-6030

Mailing address

240 S 40TH St FL 3
Philadelphia, PA 19104-6030
Phone (215) 898-7337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20190718002133 CT Order and Referring Only - DentistPractitioner - Dentist 0143555714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02847400NJMDPediatric Dentist
DS043908PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry for Special People Pediatric Dentistry PastSince Aug 1, 2021 Accepting new patients
T'Zuna Bria Publishing Company, LLC PastSince Aug 1, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1831650233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "215-898-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S 40TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191046030",
            "telephone_number": "215-898-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAN",
        "first_name": "JOANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02847400",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS043908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.