Pineo Family Dentistry LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS035169 Issued in PA

Legal business name

PINEO FAMILY DENTISTRY LLC

Practice address

606 Erie St
Edinboro, PA 16412-6002

Phone

(814) 734-4451

Fax

(814) 734-2863

NPI assigned

Aug 5, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ross Victor Pineo, DDS

Title

Owner

Phone

(814) 734-4451

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• Deveshi Chandan, DMD

  • Dentist
  • Edinboro, PA
  • NPI 1164917696
  NPD (past)
• Allan Charles Johnson Jr., D.O.

  • Family Medicine Physician
  • Erie, PA
  • NPI 1235132812
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457360018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 ERIE ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164126002",
            "telephone_number": "814-734-4451",
            "fax_number": "814-734-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 ERIE ST",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164126002",
            "telephone_number": "814-734-4451",
            "fax_number": "814-734-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEO FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PINEO",
        "authorized_official_first_name": "ROSS",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-734-4451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1384880",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011637470001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Renae Payer
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy 05095)
• Carrie J. Petkac, M.A., L.P.C.
• Megan Michelle Phillips, LCSW
• Paige A. Pilewski, MS, OTR/L
• Jessica Polivka
• Amanda Lynn Potts, LPC
• Timothy Ryan Purcell, D.C.
• Stephanie Rademacher
• Samuel James Reagan, STUDENT

• General Practice Dentistry in Edinboro, PA
• Providers in Edinboro, 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 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.