Organization Active NPI

State College Family Dentistry

  • Dental Clinic/Center
  • State College, PA
National Provider Identifier
1497562680
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STATE COLLEGE FAMILY DENTISTRY
Practice address
220 Regent CT Ste D
State College, PA 16801-7969
Phone
(814) 238-6734
NPI assigned
Dec 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Authorized official

Name
Kellie E Kline
Title
Office Manager
Phone
(814) 238-6734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

220 Regent CT Ste D
State College, PA 16801-7969

Mailing address

220 Regent CT Ste D
State College, PA 16801-7969
Phone (814) 238-6734

National Provider Directory

National Provider Directory

Locations

220 Regent Ct
Ste D
State College, PA 16801
Phone (814) 238-6734

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1497562680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 REGENT CT STE D",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017969",
            "telephone_number": "814-238-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 REGENT CT STE D",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017969",
            "telephone_number": "814-238-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE COLLEGE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "KLINE",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "814-238-6734"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.