Individual provider Active NPI

David M Niesslein, DMD

  • General Practice Dentistry
  • Farmington, PA
National Provider Identifier
1982946851
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS021230L Issued in PA
Practice address
4176 National Pike
Farmington, PA 15437-1392
Phone
(724) 329-8565
Fax
(724) 329-8901
NPI assigned
Mar 19, 2013
Last updated
Mar 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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 DS021230L PA Primary

Addresses

Primary practice location

4176 National Pike
Farmington, PA 15437-1392

Mailing address

4176 National Pike
Farmington, PA 15437-1392
Phone (724) 329-8565

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
I20160219001122 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5597060137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS021230LPAMDGeneral Practice Dentistry

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1982946851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4176 NATIONAL PIKE",
            "city": "FARMINGTON",
            "state": "PA",
            "postal_code": "154371392",
            "telephone_number": "724-329-8565",
            "fax_number": "724-329-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 NATIONAL PIKE",
            "city": "FARMINGTON",
            "state": "PA",
            "postal_code": "154371392",
            "telephone_number": "724-329-8565",
            "fax_number": "724-329-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIESSLEIN",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS021230L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, PA

Sources for this page

Verify at the official NPI Registry.