Active NPI
Sherry Lynn Raabe, PHDHP
- Public Health Dentistry
- West Sunbury, PA
National Provider Identifier
1013504083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- PHDH000248
- Practice address
- 106 Cherry Ridge LN
West Sunbury, PA 16061-2234 - Phone
- (814) 229-9352
- NPI assigned
- Dec 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH069520 | PA | |
| Public Health Dentistry | 1223D0001X | PHDH000248 | PA | Primary |
Addresses
Primary practice location
106 Cherry Ridge LN
West Sunbury, PA 16061-2234
Mailing address
106 Cherry Ridge LN
West Sunbury, PA 16061-2234
Phone (814) 229-9352
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124Q00000X | Medicaid | PA |
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 |
|---|---|---|---|
| PHDH000248 | PA | MD | Public Health Dentist |
| DH069520 | PA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610064000000",
"number": "1013504083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 CHERRY RIDGE LN",
"city": "WEST SUNBURY",
"state": "PA",
"postal_code": "160612234",
"telephone_number": "814-229-9352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 CHERRY RIDGE LN",
"city": "WEST SUNBURY",
"state": "PA",
"postal_code": "160612234",
"telephone_number": "814-229-9352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAABE",
"first_name": "SHERRY",
"middle_name": "LYNN",
"credential": "PHDHP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-24",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "PA",
"license": "DH069520",
"primary": false
},
{
"code": "1223D0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Dental Public Health",
"state": "PA",
"license": "PHDH000248",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124Q00000X",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Sunbury, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.