Blue Ridge Dental Care LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLUE RIDGE DENTAL CARE LLC

Practice address

14989 Buchanan TRL E
Blue Ridge Summit, PA 17214-9775

Phone

(717) 794-5994

NPI assigned

May 21, 2018

Last updated

May 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa Rea

Title

Bookkeeper

Phone

(717) 794-5994

Specialties & licenses 1

Addresses

Other names 1

• Blue Ridge Dental Care Other name

Locations

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526860800000",
    "number": "1922599349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 621",
            "city": "BLUE RIDGE SUMMIT",
            "state": "PA",
            "postal_code": "172140621",
            "telephone_number": "717-794-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14989 BUCHANAN TRL E",
            "city": "BLUE RIDGE SUMMIT",
            "state": "PA",
            "postal_code": "172149775",
            "telephone_number": "717-794-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A",
        "authorized_official_last_name": "REA",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "717-794-5994"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Dental Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Blue Ridge Mountain Volunteer Fire & Rescue Squad Inc
• Cornerstone Family Dentistry
• Marie Free
• Mary Jo Parkolay, MAC, LAC
• Tonya Sue Santos, LMT

• Dental Clinic/Center in Blue Ridge Summit, PA
• Providers in Blue Ridge Summit, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.