John J Brungo, DMD
Individual provider Active NPI General Practice Dentistry · New Kensington, PA
NPI 1083713481 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083713481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS 025239L (PA)
- Practice address
- 4137 Leechburg Road
State Route 56
New Kensington, PA 15068 - Phone
- (724) 335-1232
- Fax
- (724) 335-1237
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150806011098 | PA | Order and Referring Only - Dentist |
1951615780 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS 025239L | PA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John J. Brungo, DMD | Current | Accepting new patients |
Locations
4137 Leechburg Rd
#56
New Kensington, PA 15068
Phone (724) 335-1232
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS 025239L | PA | Yes |
Addresses
Primary practice location
4137 Leechburg Road
State Route 56
New Kensington, PA 15068
Mailing address
4137 Leechburg Road
State Route 56
New Kensington, PA 15068
Phone (724) 335-1232
Other providers in New Kensington, PA
- Carol L Bowen
- Autumn M Brinza
- Nicole Brown
- Shelby Brown
- Erica Brubaker
- Victoria Lee Brungo
- Nicholas Bruno
- Susan L Burket
- Emilie Burr
- Zachary Clarke Byam
All providers in New Kensington, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.