Individual provider Active NPI

John Rawa Jr., DMD

  • General Practice Dentistry
  • Latrobe, PA
National Provider Identifier
1205802352
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035480 Issued in PA
Practice address
10A Liberty LN
Latrobe, PA 15650
Phone
(724) 539-7781
Fax
(724) 539-5551
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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 DS035480 PA Primary

Addresses

Primary practice location

10A Liberty LN
Latrobe, PA 15650

Mailing address

10A Liberty LN
Latrobe, PA 15650-2772
Phone (724) 539-7781

Other identifiers 1

IdentifierTypeStateIssuer
0019107260001MedicaidPA

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
I20151231000037 PA Order and Referring Only - DentistPractitioner - Dentist 7416259809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS035480PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry With a Touch of Art, LLC Current Accepting new patients
Dentistry With a Touch of Art, LLC Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

10A Liberty Ln
Latrobe, PA 15650
Phone (724) 539-7781

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1205802352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10A LIBERTY LN",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502772",
            "telephone_number": "724-539-7781",
            "fax_number": "724-539-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10A LIBERTY LN",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "15650",
            "telephone_number": "724-539-7781",
            "fax_number": "724-539-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019107260001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

Verify at the official NPI Registry.