1699733451 NPI number — CENTRAL INTERMEDIATE UNIT

Table of content: DR. TINOUSH HEDAYAT DMD (NPI 1639809445)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699733451 NPI number — CENTRAL INTERMEDIATE UNIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL INTERMEDIATE UNIT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699733451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 LINK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST DECATUR
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16878-8317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-982-3375
Provider Business Mailing Address Fax Number:
814-342-5137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 SHADY LN STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-1985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-0884
Provider Business Practice Location Address Fax Number:
814-342-5137
Provider Enumeration Date:
05/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DANKO
Authorized Official First Name:
ABBY
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL ACCESS COORDINATOR
Authorized Official Telephone Number:
814-342-0884

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251300000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0013004870001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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