Individual provider Active NPI

Paul M Urban, DMD

  • General Practice Dentistry
  • Canonsburg, PA
National Provider Identifier
1164689279
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037317 Issued in PA
Practice address
1200 Ashwood Dr
Suite #1202
Canonsburg, PA 15317-4982
Phone
(724) 746-3240
NPI assigned
May 18, 2008
Last updated
Feb 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS037317 PA Primary

Addresses

Primary practice location

1200 Ashwood Dr
Suite #1202
Canonsburg, PA 15317-4982

Mailing address

1200 Ashwood Dr
Suite #1202
Canonsburg, PA 15317-4982
Phone (724) 746-3240

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150526000090 PA Order and Referring Only - DentistPractitioner - Dentist 9537489026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Professionals of Pennsylvania, P.C. General Practice PastSince Dec 26, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1164689279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ASHWOOD DR",
            "address_2": "SUITE #1202",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153174982",
            "telephone_number": "724-746-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ASHWOOD DR",
            "address_2": "SUITE #1202",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153174982",
            "telephone_number": "724-746-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBAN",
        "first_name": "PAUL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-18",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.