Individual provider Active NPI

Jason Anthony Pellegrino, DMD

  • General Practice Dentistry
  • Allentown, PA
National Provider Identifier
1952490047
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS031460L Issued in PA
Practice address
5920 Hamilton Blvd
Ste 101
Allentown, PA 18106
Phone
(610) 530-7901
Fax
(610) 530-7905
NPI assigned
Oct 12, 2006
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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 DS031460L PA Primary

Addresses

Primary practice location

5920 Hamilton Blvd
Ste 101
Allentown, PA 18106

Mailing address

5920 Hamilton Blvd
Ste 101
Allentown, PA 18106
Phone (610) 530-7901

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
I20150615002139 PA Order and Referring Only - DentistPractitioner - Dentist 4789995911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS031460LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jason a Pellegrino DMD PC CurrentSince Nov 9, 2025 Accepting new patients

Locations

5920 Hamilton Blvd
Ste 101
Wescosville, PA 18106
Phone (610) 530-7901

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1952490047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 HAMILTON BLVD",
            "address_2": "STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18106",
            "telephone_number": "610-530-7901",
            "fax_number": "610-530-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 HAMILTON BLVD",
            "address_2": "STE 101",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18106",
            "telephone_number": "610-530-7901",
            "fax_number": "610-530-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLEGRINO",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS031460L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.