Samuel P. Cimino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

PA-15603 Issued in PA

Practice address

790 Baltimore Pike
Concordville, PA 19331

Phone

(610) 459-3644

Fax

(610) 459-0736

NPI assigned

May 24, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samuel P. Cimino, DDS, Associates

  • General Practice Dentistry
  • Concordville, PA
  • NPI 1245441039
  NPD (past) Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356552137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 466",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "193310466",
            "telephone_number": "610-459-3644",
            "fax_number": "610-459-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BALTIMORE PIKE",
            "city": "CONCORDVILLE",
            "state": "PA",
            "postal_code": "19331",
            "telephone_number": "610-459-3644",
            "fax_number": "610-459-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMINO",
        "first_name": "SAMUEL",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "PA-15603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Bartley
• Greta Bearce
• Dedra Bradham, M.A.
• Concordville Fire and Protective Association
• Concordville Pharmacy Inc
• Michelle Cooper, MED CCC-SLP
• Francis Joseph D'Allura, BS
• Deeya Daniel, M.S.

• General Practice Dentistry in Concordville, PA
• Providers in Concordville, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.