Active NPI
Larry D Long, DMD
- General Practice Dentistry
- Youngwood, PA
National Provider Identifier
1184736878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS018708L
- Practice address
- 102 North Fourth Street
Youngwood, PA 15697-1383 - Phone
- (724) 925-3471
- Fax
- (724) 925-3471
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS018708L | PA | Primary |
Addresses
Primary practice location
102 North Fourth Street
Youngwood, PA 15697-1383
Mailing address
102 North Fourth Street
Youngwood, PA 15697-1383
Phone (724) 925-3471
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150608000945 | PA | Order and Referring Only - Oral Surgery | 0547581183 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS018708L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184736878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 NORTH FOURTH STREET",
"city": "YOUNGWOOD",
"state": "PA",
"postal_code": "156971383",
"telephone_number": "724-925-3471",
"fax_number": "724-925-3471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 NORTH FOURTH STREET",
"city": "YOUNGWOOD",
"state": "PA",
"postal_code": "156971383",
"telephone_number": "724-925-3471",
"fax_number": "724-925-3471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "LARRY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS018708L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Youngwood, PA
- Home Health Services by the Thorne Group Inc
- Homewell Senior Care Westmoreland County LLC
- Homewell Senior Care-Westmoreland County (HomeWell Senior Care)
- Innovative Wellness and Weight Loss Center
- Stephen Kelly, D.C.
- Michel Luise Maiers, O.D.
- Marc Federico PT LLC
- Maria Kimmel Marquette, PHYSICIAN ASSISTANT
- Steven E. Mills, MD
- David Mondock
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.