Active NPI
Raymond Fung, DMD
- Dentist
- Greensburg, PA
National Provider Identifier
1649765066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS041769
- Practice address
- 6185 State Route 30 Ste a
Greensburg, PA 15601-6408 - Phone
- (724) 219-2001
- NPI assigned
- Jun 27, 2018
- Last updated
- Sep 26, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS041769 | PA | Primary |
Addresses
Primary practice location
6185 State Route 30 Ste a
Greensburg, PA 15601-6408
Mailing address
5814 Elmer St
Pittsburgh, PA 15232-1916
Phone (347) 279-9572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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 |
|---|---|---|---|---|
| I20210624000907 | MI | Order and Referring Only - Dentist | 0648671966 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS041769 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537920000000",
"number": "1649765066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5814 ELMER ST",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152321916",
"telephone_number": "347-279-9572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6185 STATE ROUTE 30 STE A",
"city": "GREENSBURG",
"state": "PA",
"postal_code": "156016408",
"telephone_number": "724-219-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNG",
"first_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-27",
"last_updated": "2018-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS041769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.