Active NPI
Jeffrey William Irwin, DDS
- Dentist
- Meyersdale, PA
National Provider Identifier
1083633440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS021025L
- Practice address
- 601 Salisbury St
Meyersdale, PA 15552-1421 - Phone
- (814) 634-5961
- Fax
- (814) 634-9799
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DS021025L | PA | Primary |
Addresses
Primary practice location
601 Salisbury St
Meyersdale, PA 15552-1421
Mailing address
601 Salisbury St
Meyersdale, PA 15552-1421
Phone (814) 634-5961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160419002190 | PA | Order and Referring Only - Dentist | 5092013318 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS021025L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083633440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 SALISBURY ST",
"city": "MEYERSDALE",
"state": "PA",
"postal_code": "155521421",
"telephone_number": "814-634-5961",
"fax_number": "814-634-9799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 SALISBURY ST",
"city": "MEYERSDALE",
"state": "PA",
"postal_code": "155521421",
"telephone_number": "814-634-5961",
"fax_number": "814-634-9799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "JEFFREY",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS021025L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meyersdale, PA
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.