NPIMap

Organization Active NPI

Innovative Endodontics North

  • Endodontics
  • Sewickley, PA
National Provider Identifier
1023428679
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DS037555 Issued in PA
Legal business name
INNOVATIVE ENDODONTICS NORTH
Practice address
2593 Wexford Bayne Rd
Suite 304
Sewickley, PA 15143-8608
Phone
(724) 940-3963
Fax
(724) 940-3965
NPI assigned
May 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Dr. Michael E. Lisien, DMD
Title
President
Phone
(724) 940-3963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DS037555 PA Primary

Addresses

Primary practice location

2593 Wexford Bayne Rd
Suite 304
Sewickley, PA 15143-8608

Mailing address

2593 Wexford Bayne Rd
Suite 304
Sewickley, PA 15143-8608
Phone (724) 940-3963

National Provider Directory

National Provider Directory

Locations

2593 Wexford Bayne Rd
Ste 304
Sewickley, PA 15143
Phone (724) 940-3963

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1023428679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2593 WEXFORD BAYNE RD",
            "address_2": "SUITE 304",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151438608",
            "telephone_number": "724-940-3963",
            "fax_number": "724-940-3965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2593 WEXFORD BAYNE RD",
            "address_2": "SUITE 304",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151438608",
            "telephone_number": "724-940-3963",
            "fax_number": "724-940-3965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE ENDODONTICS NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "LISIEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-940-3963",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS037555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.