NPIMap

Organization Active NPI

Centerville Clinics Ins Dental

  • Dentist
  • Fredericktown, PA
National Provider Identifier
1194757559
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CENTERVILLE CLINICS INS DENTAL
Practice address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone
(724) 632-1680
NPI assigned
Jul 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Patricia Martos
Title
Director Finance/Personnel
Phone
(724) 632-6801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1070 Old National Pike
Fredericktown, PA 15333-2114

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-1680

National Provider Directory

National Provider Directory
Tax ID family
Centerville Clinics Inc66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194757559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS INS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTOS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "DIRECTOR FINANCE/PERSONNEL",
        "authorized_official_telephone_number": "724-632-6801"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.