Active NPI
David Douglas Maruca, DMD
- General Practice Dentistry
- Ebensburg, PA
National Provider Identifier
1508595216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS04343650
- Practice address
- 300 W Highland Ave
Ebensburg, PA 15931-1060 - Phone
- (814) 472-7022
- Fax
- (814) 472-7832
- NPI assigned
- Jun 8, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS04343650 | PA | Primary |
| Dentist | 122300000X | DS043650 | PA |
Addresses
Primary practice location
300 W Highland Ave
Ebensburg, PA 15931-1060
Mailing address
300 W Highland Ave
Ebensburg, PA 15931-1060
Phone (814) 472-7022
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 8144727022 | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS043650 | PA | MD | Dentist |
| DS04343650 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1508595216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W HIGHLAND AVE",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159311060",
"telephone_number": "814-472-7022",
"fax_number": "814-472-7832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 W HIGHLAND AVE",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159311060",
"telephone_number": "814-472-7022",
"fax_number": "814-472-7832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARUCA",
"first_name": "DAVID",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-08",
"last_updated": "2022-06-08",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS04343650",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS043650",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "8144727022",
"affiliation": "N",
"endpointDescription": "Please call office",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Please call office",
"address_1": "300 W Highland Ave",
"city": "Ebensburg",
"state": "PA",
"country_code": "US",
"postal_code": "159311060",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ebensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.