NPIMap

Organization Active NPI

Nittany Dental, Inc.

Doing business as Nittany Dental Associates

  • General Practice Dentistry
  • State College, PA
National Provider Identifier
1356462337
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035349 Issued in PA
Legal business name
NITTANY DENTAL, INC.
Doing business as
Nittany Dental Associates
Practice address
2601 Gateway Dr
Suite 250
State College, PA 16801-3213
Phone
(814) 238-0088
NPI assigned
Apr 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Leon Jeanmenne, DDSNPI 1730247933
Title
President
Phone
(814) 238-0088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS035452 PA
General Practice Dentistry 1223G0001X DS035349 PA Primary

Addresses

Primary practice location

2601 Gateway Dr
Suite 250
State College, PA 16801-3213

Mailing address

2601 Gateway Dr
Suite 250
State College, PA 16801-3213
Phone (814) 238-0088

Other names 1

  • Nittany Dental Associates Doing business as

National Provider Directory

National Provider Directory

Locations

2601 Gateway Dr
Ste 250
State College, PA 16801
Phone (814) 238-0088

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356462337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 GATEWAY DR",
            "address_2": "SUITE 250",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013213",
            "telephone_number": "814-238-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GATEWAY DR",
            "address_2": "SUITE 250",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168013213",
            "telephone_number": "814-238-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NITTANY DENTAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JEANMENNE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-238-0088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035452",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nittany Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.