Active NPI
Maria Sisco, DMD
- General Practice Dentistry
- Wexford, PA
National Provider Identifier
1982817441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS029314-L
- Practice address
- 108 Vip Dr
Wexford, PA 15090-7975 - Phone
- (724) 935-0700
- Fax
- (724) 935-2834
- NPI assigned
- May 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS029314-L | PA | Primary |
Addresses
Primary practice location
108 Vip Dr
Wexford, PA 15090-7975
Mailing address
108 Vip Dr
Wexford, PA 15090-7975
Phone (724) 935-0700
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160322002474 | PA | Order and Referring Only - Dentist | 7315244134 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS029314-L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982817441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 VIP DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150907975",
"telephone_number": "724-935-0700",
"fax_number": "724-935-2834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 VIP DR",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150907975",
"telephone_number": "724-935-0700",
"fax_number": "724-935-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISCO",
"first_name": "MARIA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS029314-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.