NPIMap

Organization Active NPI

Moshannon Valley Family Dentistry

  • General Practice Dentistry
  • Houtzdale, PA
National Provider Identifier
1720157084
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS029496L Issued in PA
Legal business name
MOSHANNON VALLEY FAMILY DENTISTRY
Practice address
439 Spring St
Houtzdale, PA 16651-1702
Phone
(814) 378-7479
Fax
(814) 378-7439
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Amy L Britton
Title
Receptionist
Phone
(814) 378-7479

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DS029496L PA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DS031452L PA

Addresses

Primary practice location

439 Spring St
Houtzdale, PA 16651-1702

Mailing address

439 Spring St
Houtzdale, PA 16651-1702
Phone (814) 378-7479

Other identifiers 4

IdentifierTypeStateIssuer
927201OtherPAUNITED CONCORDIA
0015366400003MedicaidPA
1015127030001MedicaidPA
0018194120002MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720157084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 SPRING ST",
            "city": "HOUTZDALE",
            "state": "PA",
            "postal_code": "166511702",
            "telephone_number": "814-378-7479",
            "fax_number": "814-378-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 SPRING ST",
            "city": "HOUTZDALE",
            "state": "PA",
            "postal_code": "166511702",
            "telephone_number": "814-378-7479",
            "fax_number": "814-378-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSHANNON VALLEY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRITTON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "814-378-7479",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029496L",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS031452L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "927201",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015366400003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015127030001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018194120002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houtzdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.