Active NPI
Joseph Serafin Pelly, DDS
- Dentist
- West Hazelton, PA
National Provider Identifier
1952478349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS017449-L
- Practice address
- 20 East Broad St
West Hazelton, PA 18202 - Phone
- (570) 455-8800
- Fax
- (570) 455-1561
- NPI assigned
- Nov 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | DS017449-L | PA | Primary |
Addresses
Primary practice location
20 East Broad St
West Hazelton, PA 18202
Mailing address
20 East Broad St
West Hazelton, PA 18202
Phone (570) 455-8800
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS017449-L | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelly Dental Inc 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.
-
- Dentist
- West Hazleton, PA
- NPI 1376554790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1952478349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 EAST BROAD ST",
"city": "WEST HAZELTON",
"state": "PA",
"postal_code": "18202",
"telephone_number": "570-455-8800",
"fax_number": "570-455-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 EAST BROAD ST",
"city": "WEST HAZELTON",
"state": "PA",
"postal_code": "18202",
"telephone_number": "570-455-8800",
"fax_number": "570-455-1561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLY",
"first_name": "JOSEPH",
"middle_name": "SERAFIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS017449-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hazelton, 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.