Susquehanna Family Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SUSQUEHANNA FAMILY DENTAL, LLC

Practice address

490 Susquehanna Ave
Curwensville, PA 16833-1448

Phone

(814) 236-3666

Fax

(814) 236-3666

NPI assigned

Feb 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Matthew R McKissick, DDS

Title

Owner

Phone

(814) 236-3666

Specialties & licenses 1

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.

• Michael G. Kitchen, DMD

  • General Practice Dentistry
  • Curwensville, PA
  • NPI 1043378110
  NPD (past)

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

{
    "created_epoch": "1361923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1598005639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 SUSQUEHANNA AVE",
            "city": "CURWENSVILLE",
            "state": "PA",
            "postal_code": "168331448",
            "telephone_number": "814-236-3666",
            "fax_number": "814-236-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 SUSQUEHANNA AVE",
            "city": "CURWENSVILLE",
            "state": "PA",
            "postal_code": "168331448",
            "telephone_number": "814-236-3666",
            "fax_number": "814-236-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-27",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "MCKISSICK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-236-3666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101958885006",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1982238",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Ross
• Penny Lynn Rowles, COTA/L
• Sara Mays LCSW LLC
• Jilynn L Sloppy, D.C.
• Daria Smith
• Nicole Twoey-Cieslewicz
• Rebecca Frances Uncapher, DPT
• Hayden John Walnock, BSN, RN
• Phuong T Wirths, DO

• Dentist in Curwensville, PA
• Providers in Curwensville, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.