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SULLIVAN COUNTY DENTAL CLINIC
NPI 1063704500
Dentist in Laporte, PA

Active since May 03, 2011CLIA 39D2258334 · Waiver
217 KING STREET, LAPORTE, PA 18626(570) 946-5101(570) 946-4341 Get Directions Write a Review

NPPES record last updated: May 3, 2011. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sullivan County Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SULLIVAN COUNTY DENTAL CLINIC (NPI 1063704500) is a healthcare organization registered as a dentist in Laporte, Pennsylvania and active in the NPI registry since May 2011. The organization holds a CLIA Waiver certificate valid through April 19, 2028 and lists James C Rogers, President, as its authorized official.

NPPES Registry Identity

NPI1063704500
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameSULLIVAN COUNTY ACTION,INC.
Location Address217 KING STREETLaporte, PA 18626
Mailing AddressPo Box 1Laporte, PA 18626-0001 · (570) 946-4107
Phone(570) 946-5101
Fax(570) 946-4341
Organization SubpartNo
Authorized OfficialJames C RogersPresident · (570) 946-4107
Enumeration DateMay 3, 2011
✔ NPI 1063704500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Definition
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.
Also ListedDental HygienistTaxonomy 124Q00000X
217 KING STREET, Laporte, PA 18626
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Other Names 1

Doing Business AsSullivan County Dental Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2258334

Sullivan County Lhc · Laporte, PA
Active · expires Apr 19, 2028
CLIA Number39D2258334
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateApril 20, 2026
Certificate Expiration DateApril 19, 2028
Laboratory DirectorDr. Cynthia A. Meyer
Laboratory Phone(570) 704-4651
Laboratory LocationSullivan County Lhc217 King Street, Laporte, PA 18626
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SAMUEL EDWIN SCHRACK D.O.
Family Medicine
217 KING STREET
LAPORTE, PA 18626
Sullivan County (570) 946-5101
AMBER JULIA PEDRO PA-C
Physician Assistant
217 KING STREET
LAPORTE, PA 18626
Sullivan County (570) 946-5101
RURAL HEALTH CORPORATION OF NORTHEASTERN PENNSYLVANIA
Clinic/Center (Federally Qualified Health Center (FQHC))
217 KING STREET
LAPORTE, PA 18626
Sullivan County (570) 946-5201
MRS. NINA MARIE RUPERT PHDHP
Dental Hygienist
217 KING STREET
LAPERTE, PA 18626
Sullivan County (570) 946-4363

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sullivan County Action,inc.'s NPI number?

The NPI number for Sullivan County Action,inc. is 1063704500. It was assigned to this organization in the NPPES registry on May 3, 2011. The provider is doing business as Sullivan County Dental Clinic.

Where is Sullivan County Action,inc. located?

Sullivan County Action,inc. is located at 217 King Street, Laporte, PA 18626. The listed phone number is (570) 946-5101.

What is Sullivan County Action,inc.'s specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Does Sullivan County Action,inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2258334) is associated with this NPI, valid through April 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sullivan County Action,inc. accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Sullivan County Action,inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sullivan County Action,inc. was last updated on May 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.