Thomas M Irwin Jr., DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS 023667L Issued in PA

Practice address

428 N Second Street
Philipsburg, PA 16866

Phone

(814) 342-5367

Fax

(814) 342-8044

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

State licenses

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487760583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 N SECOND STREET",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "16866",
            "telephone_number": "814-342-5367",
            "fax_number": "814-342-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 N SECOND STREET",
            "city": "PHILIPSBURG",
            "state": "PA",
            "postal_code": "16866",
            "telephone_number": "814-342-5367",
            "fax_number": "814-342-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS 023667L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "167037",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009178490002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly D Hughey, COTA
• Bruce Hutchinson, L.M.T.
• Devynn Ireland
• Victoria Ireland
• Lucas Wade Irwin, D.O.
• Rayleen S Jarrett
• Joseph Rezk
• Tava Sue Jury, BS
• Allison Jean Kardohely, PTA
• Mariah K Kasun, D.C.

• Dentist in Philipsburg, PA
• Providers in Philipsburg, PA by specialty
• Dentist 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.