Shannon J Pursel, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS029313L Issued in PA

Practice address

647 Main St
Suite 1
Johnstown, PA 15901-2140

Phone

(814) 535-5244

Fax

(814) 536-2474

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pursel Dental P.C.

  • General Practice Dentistry
  • Johnstown, PA
  • NPI 1962582965
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336236017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 MAIN ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012140",
            "telephone_number": "814-535-5244",
            "fax_number": "814-536-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 MAIN ST",
            "address_2": "SUITE 1",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159012140",
            "telephone_number": "814-535-5244",
            "fax_number": "814-536-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSEL",
        "first_name": "SHANNON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029313L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Theodore Prokop, PHYSICAL THERAPIST
• George Pueblitz, MD
• Stephanie Punchak, RN
• Pursel Dental P.C.
• Kevin M Pursel, D.M.D.
• Jimmy Pyakurel
• Rubayat Hasan Qadeer, MD
• Areesha Qadir, MD
• Lian Qian, M.D.
• Quality Life Services - Westmont, LLC

• General Practice Dentistry in Johnstown, PA
• Providers in Johnstown, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.