NPIMap

Organization Active NPI

Century Oral Surgery PC

Doing business as Russell T Wible DMD

  • Dentist
  • Hermitage, PA
National Provider Identifier
1336101070
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS027889L Issued in PA
Legal business name
CENTURY ORAL SURGERY PC
Doing business as
Russell T Wible DMD
Practice address
684 North Hermitage Rd
Hermitage, PA 16148
Phone
(724) 981-4222
Fax
(724) 981-4228
NPI assigned
Apr 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Dr. Russell Thomas Wible, DMD
Title
President
Phone
(724) 981-4222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DS027889L PA Primary

Addresses

Primary practice location

684 North Hermitage Rd
Hermitage, PA 16148

Mailing address

684 North Hermitage Rd
Hermitage, PA 16148
Phone (724) 981-4222

Other identifiers 5

IdentifierTypeStateIssuer
000000325486OtherOHONE NATION
2375673OtherAETNA HMO
204563OtherPAUPMC
4420848OtherAETNA PPO
419683OtherPABC BS

Other names 1

  • Russell T Wible DMD Doing business as

National Provider Directory

National Provider Directory

Locations

689 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 981-4222

684 N Hermitage Rd
Hermitage, PA 16148
Phone (724) 981-4222

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1336101070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 NORTH HERMITAGE RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-4222",
            "fax_number": "724-981-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 NORTH HERMITAGE RD",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-4222",
            "fax_number": "724-981-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTURY ORAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "WIBLE",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "724-981-4222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027889L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE NATION",
            "identifier": "000000325486",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2375673",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "204563",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4420848",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "419683",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russell T Wible DMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hermitage, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.