Edward Ralph Morgan, D.M.D.

Key facts

NPI

1720179815

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

DS019553-L (PA)

Practice address

400 N Chestnut St
Derry, PA 15627-1661

Phone

(724) 694-5420

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720179815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N CHESTNUT ST",
            "city": "DERRY",
            "state": "PA",
            "postal_code": "156271661",
            "telephone_number": "724-694-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N CHESTNUT ST",
            "city": "DERRY",
            "state": "PA",
            "postal_code": "156271661",
            "telephone_number": "724-694-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "EDWARD",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019553-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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