Active NPI
David Susko Jr.
- Dentist
- Pittsburgh, PA
National Provider Identifier
1578142865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS043484
- Practice address
- 3501 Terrace St
Pittsburgh, PA 15213-2523 - Phone
- (412) 648-8616
- NPI assigned
- Apr 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | RES.004348 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DS043484 | PA | Primary |
Addresses
Primary practice location
3501 Terrace St
Pittsburgh, PA 15213-2523
Mailing address
3501 Terrace St
Pittsburgh, PA 15213-2523
Other practice location 1
305 W 12th Ave
Columbus, OH 43210-1267
Phone (586) 495-1212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210706003559 | OH | Order and Referring Only - Dentist | 8123420619 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS043484 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1578142865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3501 TERRACE ST",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152132523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 TERRACE ST",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152132523",
"telephone_number": "412-648-8616"
}
],
"practiceLocations": [
{
"address_1": "305 W 12th Ave",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432101267",
"country_code": "US",
"telephone_number": "586-495-1212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUSKO",
"first_name": "DAVID",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-05",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OH",
"license": "RES.004348",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS043484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.