Premiere Anesthesia for Dentistry

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

DS036141 Issued in PA

Legal business name

PREMIERE ANESTHESIA FOR DENTISTRY

Practice address

106 Village PL
Wexford, PA 15090-5611

Phone

(724) 759-7948

Fax

(724) 759-7952

NPI assigned

Jun 5, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Valerie Grant

Title

Office Manager

Phone

(724) 759-7948

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1285047431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10154 WOODBURY DR",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909580",
            "telephone_number": "724-759-7948",
            "fax_number": "724-759-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 VILLAGE PL",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150905611",
            "telephone_number": "724-759-7948",
            "fax_number": "724-759-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE ANESTHESIA FOR DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "724-759-7948",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DS036141",
            "primary": true
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DS035406",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DS031543L",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DS029696L",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DP000682",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "PA",
            "license": "DA031643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Anesthesiology in Wexford, PA
• Providers in Wexford, PA by specialty
• Dental Anesthesiology in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.