Active NPI
Ethan Drake, D.M.D.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chambersburg, PA
National Provider Identifier
1205068368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS037559
- Practice address
- 759 Stouffer Ave
Chambersburg, PA 17201-2859 - Phone
- (717) 658-4326
- NPI assigned
- Aug 21, 2009
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS037559 | PA | Primary |
Addresses
Primary practice location
759 Stouffer Ave
Chambersburg, PA 17201-2859
Mailing address
759 Stouffer Ave
Chambersburg, PA 17201-2859
Phone (717) 658-4326
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037559 | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1205068368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 STOUFFER AVE",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172012859",
"telephone_number": "717-658-4326"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 STOUFFER AVE",
"city": "CHAMBERSBURG",
"state": "PA",
"postal_code": "172012859",
"telephone_number": "717-658-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "ETHAN",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-21",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS037559",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chambersburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.