Active NPI
Donald W Wells, DDS
- Endodontics
- State College, PA
National Provider Identifier
1073532164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS020540L
- Practice address
- 110 Regent CT
State College, PA 16801-7966 - Phone
- (814) 234-2428
- Fax
- (814) 231-0110
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS020540L | PA | Primary |
Addresses
Primary practice location
110 Regent CT
State College, PA 16801-7966
Mailing address
110 Regent CT
State College, PA 16801-7966
Phone (814) 234-2428
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112944 | Other | PA | UNITED CONCORDIA |
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 |
|---|---|---|---|
| DS020540L | PA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pelka Endodontics, LLC | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Endodontics
- State College, PA
- NPI 1609317478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073532164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 REGENT CT",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017966",
"telephone_number": "814-234-2428",
"fax_number": "814-231-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 REGENT CT",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168017966",
"telephone_number": "814-234-2428",
"fax_number": "814-231-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "DONALD",
"middle_name": "W",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS020540L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "112944",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.