Individual provider Active NPI

Kristen Vitellaro Scholl, D.M.D.

  • General Practice Dentistry
  • Yardley, PA
National Provider Identifier
1881908150
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS038422 Issued in PA
Practice address
680 Heacock Rd
Suite 102
Yardley, PA 19067
Phone
(215) 493-4021
Fax
(215) 321-4621
NPI assigned
Jul 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS038422 PA Primary

Addresses

Primary practice location

680 Heacock Rd
Suite 102
Yardley, PA 19067

Mailing address

680 Heacock Rd
Suite 102
Yardley, PA 19067
Phone (215) 493-4021

Other names 1

  • Miss Kristen Marie Vitellaro Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20150330000752 PA Order and Referring Only - DentistPractitioner - Dentist 3476870536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038422PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bucks County Smiles, Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1881908150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD",
            "address_2": "SUITE 102",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-4021",
            "fax_number": "215-321-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 HEACOCK RD",
            "address_2": "SUITE 102",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-4021",
            "fax_number": "215-321-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLL",
        "first_name": "KRISTEN",
        "middle_name": "VITELLARO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "VITELLARO",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Yardley, PA

Sources for this page

Verify at the official NPI Registry.