Individual provider Active NPI

David Edward Palo, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Erie, PA
National Provider Identifier
1821053885
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS037203 Issued in PA
Practice address
100 State Street
Suite B.102
Erie, PA 16507
Phone
(814) 454-3871
Fax
(814) 454-6294
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DA1857 HI
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS037203 PA Primary

Addresses

Primary practice location

100 State Street
Suite B.102
Erie, PA 16507

Mailing address

100 State Street
Suite B.102
Erie, PA 16507
Phone (814) 454-3871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080220000225 PA Practitioner - Oral Surgery 3779667431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 State St
Suite B102
Erie, PA 16507-1462
Phone (814) 454-3871

Hospital & facility affiliations

  • Saint Vincent Hospital Hospital, Erie, PA, CCN 390009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DA1857HIMDOral and Maxillofacial Surgery (Dentist)
DS037203PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Lehrian and Palo Oral Surgery, PC Oral and Maxillofacial Surgery CurrentSince Jan 2, 2008 Accepting new patients

Locations

100 State St
Ste B102
Erie, PA 16507
Phone (814) 454-3871

35 W Main St
North East, PA 16428
Phone (814) 725-1223

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821053885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STATE STREET",
            "address_2": "SUITE B.102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16507",
            "telephone_number": "814-454-3871",
            "fax_number": "814-454-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STATE STREET",
            "address_2": "SUITE B.102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "16507",
            "telephone_number": "814-454-3871",
            "fax_number": "814-454-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALO",
        "first_name": "DAVID",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "HI",
            "license": "DA1857",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS037203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.