Theodore Mark Morris, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS019755L Issued in PA

Practice address

2580 Brownsville Rd
South Park, PA 15129-8576

Phone

(412) 831-0520

Fax

(412) 831-3107

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407986755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1664 QUEENS DR",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151298835",
            "telephone_number": "412-655-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2580 BROWNSVILLE RD",
            "city": "SOUTH PARK",
            "state": "PA",
            "postal_code": "151298576",
            "telephone_number": "412-831-0520",
            "fax_number": "412-831-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "THEODORE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019755L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Robert Marchewka, PHARM. D.
• Michael S. McCaffrey, O.D.
• Dawn Marie McDaniel Moeller, PH.D.
• Andrew Ray Mills, PSYD
• Chad Ryan Morris, DMD
• Nationwide Medical, Inc
• Nationwide Medical, Inc
• Nirmala Nepal
• Janet K Nolan, OTR/L
• Kimberly Ann Perone, RPH

• General Practice Dentistry in South Park, PA
• Providers in South Park, 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.