Pagoda Dental Group of Wyomissing, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PAGODA DENTAL GROUP OF WYOMISSING, PLLC

Practice address

320 Abington Dr Ste 5
Wyomissing, PA 19610-1898

Phone

(509) 627-9291

NPI assigned

Jul 23, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Andrew J Giesa, DMD

Title

Owner

Phone

(509) 627-9291

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1275186728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ABINGTON DR STE 5",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101898",
            "telephone_number": "509-627-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ABINGTON DR STE 5",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101898",
            "telephone_number": "509-627-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAGODA DENTAL GROUP OF WYOMISSING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "GIESA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-627-9291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.