SULLIVAN COUNTY ACTION,INC. (NPI# 1063704500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063704500 |
| Entity Type | Organization |
| Organization Name | SULLIVAN COUNTY ACTION,INC. |
| Other Organization Name | SULLIVAN COUNTY DENTAL CLINIC |
| Practice Address |
217 King Street Laporte PA 18626 |
| Mailing Address |
Po Box 1 Laporte PA 18626-0001 |
| Practice Telephone | 5709465101 |
| Practice Fax Number | 5709464341 |
| Mailing Telephone | 5709464107 |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |
| Authorized Official Name | MR. JAMES C ROGERS (PRESIDENT) |
| Authorized Official Telephone | 5709464107 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Sullivan County Dental Clinic | Doing Business As Name - Organization |
| Street Address |
217 KING STREET |
| City | LAPORTE |
| State | PA |
| Zip Code | 18626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114926920 | Samuel Edwin Schrack | Family Medicine | 217 King Street, Laporte, PA 18626-0095 | 2005-07-14 |
| 1194791921 | Amber Julia Pedro | Physician Assistant | 217 King Street, Laporte, PA 18626-0095 | 2006-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821531971 | A Better Today, Inc. | Community/Behavioral Health | 245 Muncy Street, Sullivan County Courthouse, Laporte, PA 18626 | 2016-11-22 |
| 1205247319 | Bethany Suzanne Genevro | Speech-Language Pathologist | 918 Main Street, Laporte, PA 18626 | 2014-05-12 |
| 1922385145 | Jessica Mcfadden | Speech-Language Pathologist | 918 Main St., Laporte, PA 18626 | 2011-11-16 |
| 1295955813 | Lynda Anne Ambrose | Pharmacist | Main and King Street, Laporte, PA 18626 | 2007-04-26 |
| 1629158910 | Universal Medical Suppliers Inc | Pharmacy | Main and King Sts, Laporte, PA 18626 | 2006-10-17 |
| 1922068162 | Eric Warren Longenbach | Family Medicine | 217 King St, Laporte, PA 18626 | 2006-03-23 |
| 1194239640 | Andrea Lynn Jensen | Speech-Language Pathologist | 918 Main Street, Laporte, PA 18626 | 2017-11-20 |
| 1891093001 | Mental Health Associates of North Central Pa | Clinic/Center | Main and King Street, Laporte, PA 18626 | 2011-03-11 |
| 1891816948 | Northern Tier Counseling, Inc | Psychiatry & Neurology | Main Street, Laporte, PA 18626 | 2007-04-03 |
| 1366490864 | Guardian Elder Care At Laporte LLC | Skilled Nursing Facility | 918 Main St, Laporte, PA 18626 | 2006-05-05 |
| Find all providers in zip 18626 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164460705 | Ronald Keith Corley | Dentist | 614 Andrew Ave, Laporte, IN 46350 | 2006-06-04 |
| 1679520647 | Mark Joseph Mihalo | Dentist | 1339 W State Road 2, Laporte, IN 46350-4665 | 2006-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555426 | Andrew Morrison | Dentist | 1575 Highlands Dr Ste 100, Lititz, PA 17543-7507 | 2020-10-12 |
| 1497362982 | Samar Al Quraishi | Dentist | 625 E Lancaster Ave Apt C303, Wynnewood, PA 19096-2028 | 2020-09-28 |
| 1891301875 | Livewell Dentistry Pllc | Dentist | 125 Towne Centre Blvd Ste 510, Wexford, PA 15090-5619 | 2020-09-16 |
| 1396351318 | Mostafa Alwakeel | Dentist | 5450 Wissahickon Ave Apt B232, Philadelphia, PA 19144-5404 | 2020-09-16 |
| 1235743857 | Gurkirt Singh | Dentist | 833 N Bethlehem Pike, Spring House, PA 19477 | 2020-09-01 |
| 1245844927 | Puja Shah | Dentist | 602 S Bethlehem Pike Ste C2, Ambler, PA 19002-5800 | 2020-09-01 |
| 1932712759 | James Hickey | Dentist | 94 Egypt Hollow Rd, Warren, PA 16365 | 2020-08-31 |
| 1811508922 | Eleine Laffita Aguilera | Dentist | 4040 Spruce St Apt 5, Philadelphia, PA 19104-4130 | 2020-08-12 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1578172128 | Selena Nguyen | Dentist | 4837 N Broad St, Philadelphia, PA 19141-2107 | 2020-07-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.