NPIMap

Organization Active NPI

Specialty Periodontal Care Associates LLC

  • Periodontics
  • Bethel Park, PA
National Provider Identifier
1255434395
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS027670L Issued in PA
Legal business name
SPECIALTY PERIODONTAL CARE ASSOCIATES LLC
Practice address
4924 Lindermer Avenue
Bethel Park, PA 15102
Phone
(412) 833-6377
Fax
(412) 833-6496
NPI assigned
Sep 6, 2006
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
Robert J Locastro, DMDNPI 1629253133
Title
Owner
Phone
(724) 228-5800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DS027670L PA Primary

Addresses

Primary practice location

4924 Lindermer Avenue
Bethel Park, PA 15102

Mailing address

4924 Lindermer Avenue
Bethel Park, PA 15102
Phone (412) 833-6377

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255434395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 LINDERMER AVENUE",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "15102",
            "telephone_number": "412-833-6377",
            "fax_number": "412-833-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 LINDERMER AVENUE",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "15102",
            "telephone_number": "412-833-6377",
            "fax_number": "412-833-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PERIODONTAL CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCASTRO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-228-5800",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS027670L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel Park, 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.