John B Fitzgerald III, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DS024621L Issued in PA

Practice address

1201 W Swedesford Road
Berwyn, PA 19312

Phone

(610) 296-9990

Fax

(610) 296-9993

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Chesterbrook Dental Associates, LTD.

  • General Practice Dentistry
  • Berwyn, PA
  • NPI 1528280971
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962624312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 MIDLAND CIR",
            "city": "ST DAVIDS",
            "state": "PA",
            "postal_code": "190875002",
            "telephone_number": "610-971-2121",
            "fax_number": "610-296-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W SWEDESFORD ROAD",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "19312",
            "telephone_number": "610-296-9990",
            "fax_number": "610-296-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS024621L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Eric Everitt, M.D.
• Miyoshi Faggins, M.ED
• Amanda Lea Farrell, MSN, CRNP
• Eva Fedick, LSW, M.ED
• Andrew Joseph Fetterman, D.C.
• Joycelyn Fletcher
• Lauren Cordes Flynn, D.O.
• Margareth Fontaine
• Kyle Fry
• Lucy Fulton, OT/R

• Dentist in Berwyn, PA
• Providers in Berwyn, PA by specialty
• Dentist in Pennsylvania

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.