Beaver Valley Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS030094L Issued in PA

Legal business name

BEAVER VALLEY DENTAL, LLC

Practice address

546 Merchant St
Ambridge, PA 15003-2463

Phone

(724) 266-2099

Fax

(724) 266-5388

NPI assigned

Oct 31, 2007

Last updated

Oct 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tricia Ciarimboli

Title

Regional Manager

Phone

(724) 266-2099

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Akuvi Mamu Kloutse, DMD

  • General Practice Dentistry
  • Ambridge, PA
  • NPI 1962554956
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1548449176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 MERCHANT ST",
            "city": "AMBRIDGE",
            "state": "PA",
            "postal_code": "150032463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 MERCHANT ST",
            "city": "AMBRIDGE",
            "state": "PA",
            "postal_code": "150032463",
            "telephone_number": "724-266-2099",
            "fax_number": "724-266-5388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER VALLEY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "CIARIMBOLI",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "724-266-2099"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036432",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS030094L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018235160001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017686540006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Augustine, RPH
• Nellie Kay Barclay-Cervi, LPN
• Mara Ann Bartholomew, M.S., CCC-SLP
• Michael Bauer
• Beaver County Pathways LLC (Pathways)
• Beaver Valley Foot Clinic PC
• Tad Justin Borland, DPM
• Amber Bozza, RN
• Nicholas Joseph Bozza, PHARMD
• Bridge Counseling LLC

• General Practice Dentistry in Ambridge, PA
• Providers in Ambridge, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.