Individual provider Active NPI

Anthony Joseph Dangelo Jr., DMD

  • Dentist
  • Hazleton, PA
National Provider Identifier
1891801072
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS027314L Issued in PA
Practice address
101 W Broad St Suite 503
Hazleton, PA 18201
Phone
(570) 454-3820
Fax
(570) 454-0321
NPI assigned
Aug 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS027314L PA Primary

Addresses

Primary practice location

101 W Broad St Suite 503
Hazleton, PA 18201

Mailing address

101 W Broad St Suite 503
Hazleton, PA 18201
Phone (570) 454-3820

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS027314LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891801072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W BROAD ST SUITE 503",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18201",
            "telephone_number": "570-454-3820",
            "fax_number": "570-454-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W BROAD ST SUITE 503",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "18201",
            "telephone_number": "570-454-3820",
            "fax_number": "570-454-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANGELO",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027314L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazleton, PA

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.

Verify at the official NPI Registry.