Active NPI
David A Moffa, DMD
- Dentist
- Greensburg, PA
National Provider Identifier
1356517106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS021701L
- Practice address
- 259 Old Route 30
Suite D
Greensburg, PA 15601 - Phone
- (724) 836-6884
- Fax
- (724) 836-4616
- NPI assigned
- May 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS021701L | PA | Primary |
| Dentist | 122300000X | DN11850 | FL |
Addresses
Primary practice location
259 Old Route 30
Suite D
Greensburg, PA 15601
Mailing address
259 Old Route 30
Suite D
Greensburg, PA 15601
Phone (724) 836-6884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN11850 | FL | MD | Dentist |
| DS021701L | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Petnuch DMD PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Willowbrook Dental Associates
- General Practice Dentistry
- Greensburg, PA
- NPI 1588672588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1356517106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 OLD ROUTE 30",
"address_2": "SUITE D",
"city": "GREENSBURG",
"state": "PA",
"postal_code": "15601",
"telephone_number": "724-836-6884",
"fax_number": "724-836-4616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 OLD ROUTE 30",
"address_2": "SUITE D",
"city": "GREENSBURG",
"state": "PA",
"postal_code": "15601",
"telephone_number": "724-836-6884",
"fax_number": "724-836-4616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFA",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-01",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS021701L",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN11850",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.