Western Pennsylvania Oral and Maxillofacial Surgery PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS030642L Issued in PA

Legal business name

WESTERN PENNSYLVANIA ORAL AND MAXILLOFACIAL SURGERY PC

Practice address

2112 N Franklin Drive
Suite 2
Washington, PA 15301-1530

Phone

(724) 223-0579

NPI assigned

Jun 13, 2007

Last updated

Dec 16, 2019By 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

Kathleen Bentlejewski

Title

Office Manager

Phone

(724) 223-0579

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 5

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.

• Ali Nili, DMD, MS

  • Dentist
  • Washington, PA
  • NPI 1720650203
  Medicare reassignment NPD
• Steven M Krakora, D.M.D., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Washington, PA
  • NPI 1366409799
  Medicare reassignment
• Sara Elizabeth Greb, PA-C

  • Physician Assistant
  • Washington, PA
  • NPI 1407605975
  NPD
• Allyson O'Connell, CRNP

  • Family Nurse Practitioner
  • Washington, PA
  • NPI 1730995705
  NPD
• Katie Harris, PA-C

  • Physician Assistant
  • Mt Pleasant, PA
  • NPI 1639711526
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1578767463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 N FRANKLIN DR",
            "address_2": "SUITE 2",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153015892",
            "telephone_number": "724-223-0579",
            "fax_number": "724-223-0597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 N FRANKLIN DRIVE",
            "address_2": "SUITE 2",
            "city": "WASHINGTON",
            "state": "PA",
            "postal_code": "153011530",
            "telephone_number": "724-223-0579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 N Franklin Dr",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "PA",
            "postal_code": "153015892",
            "country_code": "US",
            "telephone_number": "724-223-0579",
            "fax_number": "724-223-0597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Johnson Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Steubenville",
            "state": "OH",
            "postal_code": "439522372",
            "country_code": "US",
            "telephone_number": "740-264-5300",
            "fax_number": "740-264-4548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WESTERN PENNSYLVANIA ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "BENTLEJEWSKI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "724-223-0579"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS030642L",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "DA031589",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Spectrum Services
• Wesley Spectrum Services
• Wesley Spectrum Services
• Wesley Spectrum Services
• West Dermatology of Pennsylvania a Professional Medical Corporation
• Western Pennsylvania Surgical Specialists LLC
• Antoinette M. Weston, L.P.C.
• Natalie C Wetzel, PTA
• Toni Whartenby, MPT
• Heather Lynn White, CRNP

• Oral and Maxillofacial Surgery (Dentist) in Washington, PA
• Providers in Washington, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.