Organization Active NPI

Family Dentistry Associates of Johnstown PC

  • Dentist
  • Johnstown, PA
National Provider Identifier
1548320559
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS16788L Issued in PA
Legal business name
FAMILY DENTISTRY ASSOCIATES OF JOHNSTOWN PC
Practice address
223 Main Street
Johnstown, PA 15901-1553
Phone
(814) 535-7894
Fax
(814) 535-7896
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wayne J Pappert, DMD
Title
President
Phone
(814) 535-7894

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS16788L PA Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS26517L PA

Addresses

Primary practice location

223 Main Street
Johnstown, PA 15901-1553

Mailing address

223 Main Street
Johnstown, PA 15901-1553
Phone (814) 535-7894

Other identifiers 1

IdentifierTypeStateIssuer
0005721600001MedicaidPA

National Provider Directory

National Provider Directory

Locations

223 Main St
Johnstown, PA 15901
Phone (814) 535-7894

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548320559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MAIN STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011553",
            "telephone_number": "814-535-7894",
            "fax_number": "814-535-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 MAIN STREET",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011553",
            "telephone_number": "814-535-7894",
            "fax_number": "814-535-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY ASSOCIATES OF JOHNSTOWN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PAPPERT",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-535-7894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS16788L",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS26517L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005721600001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.