Epp Pennsylvania PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

EPP PENNSYLVANIA PLLC

Practice address

1220 Valley Forge Rd Ste 40
Phoenixville, PA 19460-2676

Phone

(610) 917-9984

NPI assigned

Oct 17, 2024

Organization subpart

No

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

Authorized official

Name

Jason Bertollini

Title

Credentialing Manager

Phone

(315) 450-0763

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1992526586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1584",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370241584",
            "telephone_number": "315-450-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 VALLEY FORGE RD STE 40",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194602676",
            "telephone_number": "610-917-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPP PENNSYLVANIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "315-450-0763"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Jean Earl, L.C.S.W.
• Angela Eberhardt, BA
• John M Egan, DO
• Gabrielle Eichelberger, LCSW
• Tekia Emerson
• Sara Erb
• Jennifer Elizabeth Erickson, LSW
• Lori Ann Ermish
• Nancy Anne Esser, PT
• Eternal Renewal, LLC

• Endodontics in Phoenixville, PA
• Providers in Phoenixville, PA by specialty
• Endodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.