NPIMap

Organization Active NPI

Titusville Hospital Dental Group

  • Dental Clinic/Center
  • Titusville, PA
National Provider Identifier
1174704696
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TITUSVILLE HOSPITAL DENTAL GROUP
Practice address
406 W Oak St
Titusville, PA 16354-1404
Phone
(800) 950-1851
Fax
(814) 827-8419
NPI assigned
Nov 27, 2007
Organization subpart
Yes
Parent organization
TITUSVILLE AREA HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Richard A Smith
Title
Director Clinic Operations
Phone
(800) 950-1851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

406 W Oak St
Titusville, PA 16354-1404

Mailing address

406 W Oak St
Titusville, PA 16354-1499
Phone (800) 950-1851

Other identifiers 1

IdentifierTypeStateIssuer
1007460650026MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Titusville Hospital9 organizations share this tax ID, including this one
Part of
Titusville Hospital

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1174704696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W OAK ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541499",
            "telephone_number": "800-950-1851",
            "fax_number": "814-827-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W OAK ST",
            "city": "TITUSVILLE",
            "state": "PA",
            "postal_code": "163541404",
            "telephone_number": "800-950-1851",
            "fax_number": "814-827-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TITUSVILLE HOSPITAL DENTAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TITUSVILLE AREA HOSPITAL",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR CLINIC OPERATIONS",
        "authorized_official_telephone_number": "800-950-1851"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007460650026",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.