STATE COLLEGE FAMILY DENTISTRY
NPI 1497562680
Clinic/Center - Dental in State College, PA

NPI Status: Active since December 12, 2024

Contact Information

220 REGENT CT STE D
STATE COLLEGE, PA
ZIP 16801
Phone: (814) 238-6734

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  • Organization
  • Clinic/Center
  • Dental
  • CLIA Number: 39D2042348
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 06-10-2028

About STATE COLLEGE FAMILY DENTISTRY

This page provides the complete NPI Profile along with additional information for State College Family Dentistry, a provider established in State College, Pennsylvania operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1497562680 assigned on December 2024. The practitioner's primary taxonomy code is 261QD0000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Kellie E Kline (Office Manager)

NPI
1497562680
Provider Name
STATE COLLEGE FAMILY DENTISTRY
Entity Type
Organization
Location Address
220 REGENT CT STE D STATE COLLEGE, PA 16801
Location Phone
(814) 238-6734
Mailing Address
220 REGENT CT STE D STATE COLLEGE, PA 16801
Mailing Phone
(814) 238-6734
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-12-2024
Last Update Date
12-12-2024
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KELLIE E KLINE

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(814) 238-6734

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D2042348
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
June 11, 2026
Certificate Expiration Date
June 10, 2028
Laboratory Director
DR. STACY L. ANDERSEN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to State College Family Dentistry to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1497562680, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
7
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
6
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 5 → 10 → 1 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 1 + 0 + 6 + 4 + 6 + 1 + 6 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1497562680.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497562680, enumerated as an "organization" on December 12, 2024.

The provider is located at 220 REGENT CT STE D STATE COLLEGE, PA 16801 and the phone number is (814) 238-6734.

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.