Whitehall Dental Assoc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS031269L Issued in PA

Legal business name

WHITEHALL DENTAL ASSOC

Practice address

450 Pershing Blvd
Whitehall, PA 18052-6452

Phone

(610) 434-6796

Fax

(610) 434-6671

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Nidal Yacoub, DMD, MDSNPI 1508911819

Title

Owner/Dentist

Phone

(610) 360-9625

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 4

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.

• Nidal Yacoub, D.M.D, M.D.S

  • General Practice Dentistry
  • Whitehall, PA
  • NPI 1508911819
  NPD (past) Authorized official
• Leslie Cormier, D.O

  • Internal Medicine Physician
  • Center Valley, PA
  • NPI 1891921946
  NPD (past)
• Dennis Joseph Giangiulio, M.D.

  • Hematology & Oncology Physician
  • Easton, PA
  • NPI 1326041153
  NPD (past)
• Michael Jarrouj

  • General Practice Dentistry
  • Whitehall, PA
  • NPI 1477609360
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521590400000",
    "number": "1639168701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PERSHING BLVD",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180526452",
            "telephone_number": "610-434-6796",
            "fax_number": "610-434-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PERSHING BLVD",
            "city": "WHITEHALL",
            "state": "PA",
            "postal_code": "180526452",
            "telephone_number": "610-434-6796",
            "fax_number": "610-434-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEHALL DENTAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2018-03-21",
        "status": "A",
        "authorized_official_last_name": "YACOUB",
        "authorized_official_first_name": "NIDAL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "610-360-9625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS031269L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1799436",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018794480004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Weis Markets Inc (Weis Pharmacy)
• Maryann Theresa Weisman, M.D., M.S., B.A.
• Glenn S. Weiss
• Rachael Marie Weitknecht, DPT
• Brianna Faye Rose Westover
• Whitehall Dental Group LLC
• Whitehall Medical Associates, LLC
• Whitehall-Coplay School District
• Mary Ellen Williams, D.O.
• Margaret Disalvi Wolf, OT/L

• General Practice Dentistry in Whitehall, PA
• Providers in Whitehall, 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 Mar 21, 2018; 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.