William A Celko, D.M.D.

Individual provider Active NPI General Practice Dentistry · Tarentum, PA

NPI 1114081908 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1114081908
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS022891L (PA)
Practice address
415 E 4TH Ave
Tarentum, PA 15084-1847
Phone
(724) 224-3116
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS022891LPAMDGeneral Practice Dentistry

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19153/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS022891L PA Yes

Addresses

Primary practice location

415 E 4TH Ave
Tarentum, PA 15084-1847

Mailing address

415 E 4TH Ave
Tarentum, PA 15084-1847
Phone (724) 224-3116

Other providers in Tarentum, PA

All providers in Tarentum, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.