Individual provider Active NPI

Susan I Susang, DMD

  • Dentist
  • Greensburg, PA
National Provider Identifier
1841369501
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS026066L Issued in PA
Practice address
593 Rugh St
Greensburg, PA 15601
Phone
(724) 834-4565
Fax
(724) 834-4578
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS026066L PA Primary

Addresses

Primary practice location

593 Rugh St
Greensburg, PA 15601

Mailing address

593 Rugh St
Greensburg, PA 15601
Phone (724) 834-4565

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
I20150616002061 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305157413

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS026066LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841369501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 RUGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "15601",
            "telephone_number": "724-834-4565",
            "fax_number": "724-834-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 RUGH ST",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "15601",
            "telephone_number": "724-834-4565",
            "fax_number": "724-834-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSANG",
        "first_name": "SUSAN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS026066L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

Verify at the official NPI Registry.