Pasquale Carmen Damico, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS15607 Issued in PA

Practice address

190 N Pennsylvania Ave
Wilkes Barre, PA 18701-3605

Phone

(570) 970-2864

NPI assigned

Jul 22, 2013

Last updated

Jul 22, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1104268978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2981 E VINA DEL MAR BLVD",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337062726",
            "telephone_number": "727-504-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013605",
            "telephone_number": "570-970-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "PASQUALE",
        "middle_name": "CARMEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS15607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DS15607",
            "identifier": "DS15607",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew William Dacey, PHARMD
• Abdellaziz Dahou, MD
• Atul Odhavji Dalsania, M.D.
• Kelly Jo Dalton, O.D.
• Allyson Daly, DO
• Vani Dandolu, MD
• John F. Danella, M.D.
• Todd C Daniello, MD
• Colleen Daniels
• Thomas Daniels, PA-C

• Dentist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.