Pottsville Pediatric Dental Center

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS035069 Issued in PA

Legal business name

POTTSVILLE PEDIATRIC DENTAL CENTER

Practice address

305 N 2ND St
Pottsville, PA 17901-2503

Phone

(570) 622-7430

NPI assigned

Mar 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Preciosa Perez, DDS

Title

Partner

Phone

(570) 622-7430

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300147200000",
    "number": "1831498971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N 2ND ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012503",
            "telephone_number": "570-622-7430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N 2ND ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012503",
            "telephone_number": "570-622-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTSVILLE PEDIATRIC DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "PRECIOSA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "570-622-7430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS031182L",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS035069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001883048-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pottsville Internists Associates, Inc
• Pottsville Medical Services, LLC
• Pottsville Operations LLC
• Pottsville Oral Surgery, PC
• Pottsville Peace of Mind LLC
• Pottsville Radiology Associates
• Pottsville Rehabilitation LLC
• Pottsville Sleep Physicians LLC
• Pottsville SNF Operations LLC
• Pottsville Sports & Rehabilitation Center, Inc.

• Pediatric Dentistry in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; 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.