Individual provider Active NPI

Melissa M Brungo

  • General Practice Dentistry
  • Pittsburgh, PA
National Provider Identifier
1942398474
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS036974 Issued in PA
Practice address
440 Perry Hwy
Pittsburgh, PA 15229-1843
Phone
(412) 931-4243
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X DS036974 PA Primary

Addresses

Primary practice location

440 Perry Hwy
Pittsburgh, PA 15229-1843

Mailing address

440 Perry Hwy
Pittsburgh, PA 15229-1843
Phone (412) 931-4243

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
I20160302001372 PA Order and Referring Only - DentistPractitioner - Dentist 4587960489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS036974PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
G.a. & J.a. Brungo & Assoc. LTD Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942398474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 PERRY HWY",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152291843",
            "telephone_number": "412-931-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 PERRY HWY",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152291843",
            "telephone_number": "412-931-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNGO",
        "first_name": "MELISSA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.