Penn Dental Solutions LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PENN DENTAL SOLUTIONS LLC

Doing business as

Progressive Dental Solutions

Practice address

3055 Washington Rd Ste 303
MC Murray, PA 15317-3279

Phone

(724) 942-5630

Fax

(724) 942-5632

NPI assigned

Feb 13, 2019

Last updated

Feb 13, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Edward Bienvenido Minaya

Title

Owner

Phone

(814) 232-7985

Specialties & licenses 1

Addresses

Other names 1

• Progressive Dental Solutions Doing business as

Locations

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550016000000",
    "number": "1316403454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 WASHINGTON RD STE 303",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173279",
            "telephone_number": "724-942-5630",
            "fax_number": "724-942-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 WASHINGTON RD STE 303",
            "city": "MC MURRAY",
            "state": "PA",
            "postal_code": "153173279",
            "telephone_number": "724-942-5630",
            "fax_number": "724-942-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN DENTAL SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A",
        "authorized_official_last_name": "MINAYA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "BIENVENIDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-232-7985",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Progressive Dental Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kristen Emily Mestayer Peske, D.O.
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• Matthew Shane Petrie, M.D.

• Dental Clinic/Center in McMurray, PA
• Providers in McMurray, 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 Feb 13, 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.