John W. Clemenza, DMD, MD Oral and Facial Surgical Center, LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

JOHN W. CLEMENZA, DMD, MD ORAL AND FACIAL SURGICAL CENTER, LLC

Practice address

3041 Innovation Way
Hermitage, PA 16148

Phone

(724) 981-8884

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

John William Clemenza, D.M.D., M.D.

Title

Member

Phone

(724) 981-8884

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1699723494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 INNOVATION WAY",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 INNOVATION WAY",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "16148",
            "telephone_number": "724-981-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. CLEMENZA, DMD, MD ORAL AND FACIAL SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "CLEMENZA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "724-981-8884",
        "authorized_official_credential": "D.M.D., M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/ BS",
            "identifier": "974553",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Hermitage, PA
• Providers in Hermitage, 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 Mar 17, 2008; 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.