Active NPI
Brookville Dental PC
- General Practice Dentistry
- Brookville, PA
National Provider Identifier
1891719480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS024744L
- Legal business name
- BROOKVILLE DENTAL PC
- Practice address
- 123 Main St
Brookville, PA 15825-1212 - Phone
- (814) 849-2652
- NPI assigned
- Jul 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William J Weaver, D.M.D.
- Title
- President
- Phone
- (814) 849-2652
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS024744L | PA | Primary |
Addresses
Primary practice location
123 Main St
Brookville, PA 15825-1212
Mailing address
123 Main St
Brookville, PA 15825-1212
Phone (814) 849-2652
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018235500001 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
123 Main St
Brookville, PA 15825
Phone (814) 849-2652
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1891719480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 MAIN ST",
"city": "BROOKVILLE",
"state": "PA",
"postal_code": "158251212",
"telephone_number": "814-849-2652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 MAIN ST",
"city": "BROOKVILLE",
"state": "PA",
"postal_code": "158251212",
"telephone_number": "814-849-2652"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BROOKVILLE DENTAL PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WEAVER",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "814-849-2652",
"authorized_official_credential": "D.M.D."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS024744L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018235500001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.