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IDP PUNXSUTAWNEY LLC
NPI 1245672419
Dentist - General Practice in Punxsutawney, PA

Active since July 29, 2013
219 N MAIN ST, PUNXSUTAWNEY, PA 15767(814) 938-2222(814) 938-0931 Get Directions Write a Review

NPPES record last updated: July 29, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Idp Punxsutawney Llc NPPES

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

IDP PUNXSUTAWNEY LLC (NPI 1245672419), doing business as John Regis Smelko, is a healthcare organization registered as a general practice in Punxsutawney, Pennsylvania and active in the NPI registry since July 2013. The organization lists Julie Smith, Operations Facilitator, as its authorized official.

NPPES Registry Identity

NPI1245672419
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameIDP PUNXSUTAWNEY LLC
Location Address219 N MAIN STPunxsutawney, PA 15767-1217
Mailing Address219 N Main StPunxsutawney, PA 15767-1217 · (814) 938-2222 · Fax (814) 938-0931
Phone(814) 938-2222
Fax(814) 938-0931
Organization SubpartNo
Authorized OfficialJulie SmithOperations Facilitator · (231) 739-5105
Enumeration DateJuly 29, 2013
✔ NPI 1245672419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in PA · DS018913L
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
219 N MAIN ST, Punxsutawney, PA 15767
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Other Names 1

Former Legal Business NameJohn Regis Smelko

Other Identifiers 1

Medicaid0006936660001PA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Idp Punxsutawney LLC's NPI number?

The NPI number for Idp Punxsutawney LLC is 1245672419. It was assigned to this organization in the NPPES registry on July 29, 2013. The provider was formerly known as John Regis Smelko.

Where is Idp Punxsutawney LLC located?

Idp Punxsutawney LLC is located at 219 N Main St, Punxsutawney, PA 15767. The listed phone number is (814) 938-2222.

What is Idp Punxsutawney LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Idp Punxsutawney LLC was last updated on July 29, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.