Individual provider Active NPI

Cana Edward Pasierb, D.D.S.

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1376856690
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS039022 Issued in PA
Practice address
3700 Market St
Suite 101
Philadelphia, PA 19104-3147
Phone
(215) 387-0883
Fax
(215) 387-9659
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS039022 PA Primary

Addresses

Primary practice location

3700 Market St
Suite 101
Philadelphia, PA 19104-3147

Mailing address

3700 Market St
Suite 101
Philadelphia, PA 19104-3147
Phone (215) 387-0883

Other identifiers 1

IdentifierTypeStateIssuer
DS0309022OtherPAPA DENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515000696 PA Order and Referring Only - DentistPractitioner - Dentist 1355661224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343865600000",
    "number": "1376856690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 MARKET ST",
            "address_2": "SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043147",
            "telephone_number": "215-387-0883",
            "fax_number": "215-387-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 MARKET ST",
            "address_2": "SUITE 101",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043147",
            "telephone_number": "215-387-0883",
            "fax_number": "215-387-9659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASIERB",
        "first_name": "CANA",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2012-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA DENTAL LICENSE",
            "identifier": "DS0309022",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.