Healthcare Provider Details

I. General information

NPI: 1023812021
Provider Name (Legal Business Name): JOHN ELLIOT DELLALANA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2091 FRUITVILLE PIKE
LANCASTER PA
17601-3917
US

IV. Provider business mailing address

1035 14TH AVE N
NASHVILLE TN
37208-3050
US

V. Phone/Fax

Practice location:
  • Phone: 203-275-7865
  • Fax:
Mailing address:
  • Phone: 615-327-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS046008
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: