NPIMap

Organization Active NPI

Penn Valley Dental

  • Dentist
  • Sayre, PA
National Provider Identifier
1023406220
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS036085 Issued in PA
Legal business name
PENN VALLEY DENTAL
Practice address
408 N Keystone Ave
Sayre, PA 18840-1825
Phone
(570) 888-5811
Fax
(570) 888-5607
NPI assigned
Dec 23, 2014
Last updated
Dec 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Dr. Rahool Patel
Title
Owner
Phone
(732) 735-5337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS036085 PA Primary

Addresses

Primary practice location

408 N Keystone Ave
Sayre, PA 18840-1825

Mailing address

408 N Keystone Ave
Sayre, PA 18840-1825
Phone (570) 888-5811

National Provider Directory

National Provider Directory

Locations

408 N Keystone Ave
Sayre, PA 18840
Phone (570) 888-4800

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1419292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1023406220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N KEYSTONE AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401825",
            "telephone_number": "570-888-5811",
            "fax_number": "570-888-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N KEYSTONE AVE",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401825",
            "telephone_number": "570-888-5811",
            "fax_number": "570-888-5607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-23",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAHOOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-735-5337",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS036085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sayre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.