Edward Anthony Maruca Jr., DENTIST

Primary specialty

DentistTaxonomy code 122300000X

License

DS015925L Issued in PA

Practice address

1041 3 Avenue
Duncansville, PA 16635

Phone

(814) 695-0920

Fax

(814) 695-0926

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1285754374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 3 AVENUE",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "16635",
            "telephone_number": "814-695-0920",
            "fax_number": "814-695-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 3 AVENUE",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "16635",
            "telephone_number": "814-695-0920",
            "fax_number": "814-695-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUCA",
        "first_name": "EDWARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS015925L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005115110001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neal H. Locker, DMD
• Evan Ludwig, DC
• Catherine J Lunger
• Shelby Madden
• Jennifer Makowiecki, PTA
• Ann Elizabeth Matson-Logue, PT
• Jonathan Paul Mazur, DPT
• Beth McCahren, RN
• Lisa Rose McCarthy, PA-C
• Kelly Jo McClellan, LPN

• Dentist in Duncansville, PA
• Providers in Duncansville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.