Individual provider Active NPI

Roger M Sepich, D.D.S.

  • Dentist
  • Saxonburg, PA
National Provider Identifier
1508912346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS025777L Issued in PA
Practice address
559 West Main Street
Saxonburg, PA 16056
Phone
(724) 352-4440
Fax
(724) 352-0218
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS025777L PA Primary

Addresses

Primary practice location

559 West Main Street
Saxonburg, PA 16056

Mailing address

559 West Main Street
P.O. Box 715
Saxonburg, PA 16056
Phone (724) 352-4440

Other identifiers 1

IdentifierTypeStateIssuer
427377OtherPAUNITED CONCORDIA #

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307001253 PA Order and Referring Only - Family PracticePractitioner - Family Practice 4183920895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508912346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 WEST MAIN STREET",
            "address_2": "P.O. BOX 715",
            "city": "SAXONBURG",
            "state": "PA",
            "postal_code": "16056",
            "telephone_number": "724-352-4440",
            "fax_number": "724-352-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 WEST MAIN STREET",
            "city": "SAXONBURG",
            "state": "PA",
            "postal_code": "16056",
            "telephone_number": "724-352-4440",
            "fax_number": "724-352-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPICH",
        "first_name": "ROGER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS025777L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA #",
            "identifier": "427377",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saxonburg, PA

Sources for this page

Verify at the official NPI Registry.