NPIMap

Organization Active NPI

Pennsylvania Dental Specialty Group, PC

  • Periodontics
  • Lancaster, PA
National Provider Identifier
1487034005
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
PENNSYLVANIA DENTAL SPECIALTY GROUP, PC
Practice address
101 N Pointe Blvd
Suite 202
Lancaster, PA 17601-4108
Phone
(717) 590-1513
Fax
(484) 731-9015
NPI assigned
Jun 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Jessie Winkler
Title
Revenue Cycle Manager
Phone
(717) 590-1513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

101 N Pointe Blvd
Suite 202
Lancaster, PA 17601-4108

Mailing address

101 N Pointe Blvd
Suite 202
Lancaster, PA 17601-4108
Phone (717) 590-1513

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1487034005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N POINTE BLVD",
            "address_2": "SUITE 202",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014108",
            "telephone_number": "717-590-1513",
            "fax_number": "484-731-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N POINTE BLVD",
            "address_2": "SUITE 202",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014108",
            "telephone_number": "717-590-1513",
            "fax_number": "484-731-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DENTAL SPECIALTY GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "WINKLER",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "717-590-1513"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2015; 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.