Provider Demographics
NPI:1609289289
Name:NEW DIMENSION DENTISTRY
Entity Type:Organization
Organization Name:NEW DIMENSION DENTISTRY
Other - Org Name:WESTERN PENNSYLVANIA DENTAL SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:POLLINA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-269-9731
Mailing Address - Street 1:1253 SCALP AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3137
Mailing Address - Country:US
Mailing Address - Phone:814-269-9731
Mailing Address - Fax:814-266-5881
Practice Address - Street 1:1253 SCALP AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3137
Practice Address - Country:US
Practice Address - Phone:814-269-9731
Practice Address - Fax:814-266-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023871L332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01551950Medicaid