Organization Active NPI

David M Shemo DMD

  • Dentist
  • Wilkes Barre, PA
National Provider Identifier
1679827018
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DAVID M SHEMO DMD
Practice address
360 Kidder St
Suite 5
Wilkes Barre, PA 18702-5619
Phone
(570) 822-4065
Fax
(570) 820-9836
NPI assigned
Nov 7, 2012
Last updated
Nov 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Authorized official

Name
Mrs. Georgianne Smith
Title
Office Manager
Phone
(570) 822-4065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

360 Kidder St
Suite 5
Wilkes Barre, PA 18702-5619

Mailing address

360 Kidder St
Suite 5
Wilkes Barre, PA 18702-5619
Phone (570) 822-4065

National Provider Directory

National Provider Directory

Locations

360 Kidder St
City of Wilkes Barre, PA 18702
Phone (570) 425-7051

360 Kidder St
Ste 5
City of Wilkes Barre, PA 18702
Phone (570) 822-4065

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1679827018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 KIDDER ST",
            "address_2": "SUITE 5",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025619",
            "telephone_number": "570-822-4065",
            "fax_number": "570-820-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 KIDDER ST",
            "address_2": "SUITE 5",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187025619",
            "telephone_number": "570-822-4065",
            "fax_number": "570-820-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M SHEMO DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "GEORGIANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "570-822-4065",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.