Active NPI
Damian Mariano
- Orthodontics and Dentofacial Orthopedics Dentistry
- State College, PA
National Provider Identifier
1881144772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DS039960
- Practice address
- 1951 Pine Hall Rd Ste 200
State College, PA 16801-5108 - Phone
- (814) 826-2055
- NPI assigned
- Oct 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DS039960 | PA | Primary |
Addresses
Primary practice location
1951 Pine Hall Rd Ste 200
State College, PA 16801-5108
Mailing address
1066 Route 414 Hwy
Waterville, PA 17776-9511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039960 | PA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475539200000",
"number": "1881144772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1066 ROUTE 414 HWY",
"city": "WATERVILLE",
"state": "PA",
"postal_code": "177769511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1951 PINE HALL RD STE 200",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168015108",
"telephone_number": "814-826-2055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANO",
"first_name": "DAMIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-04",
"last_updated": "2016-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "PA",
"license": "DS039960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.