David Mondock
Individual provider Active NPI Dentist · Youngwood, PA
NPI 1477944494 · NPPES record last updated Feb 12, 2015
Key facts
- NPI
- 1477944494
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS026883L (PA)
- Practice address
- 621 S 5TH St
Youngwood, PA 15697-1112 - Phone
- (724) 925-6816
- NPI assigned
- Feb 12, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160328001990 | PA | Order and Referring Only - Dentist |
2961709423 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. David J. Mondock DMD PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS026883L | PA | Yes |
Addresses
Primary practice location
621 S 5TH St
Youngwood, PA 15697-1112
Mailing address
621 S 5TH St
Youngwood, PA 15697-1112
Other providers in Youngwood, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.