Active NPI
Theodore David Opperman, DMD
- General Practice Dentistry
- Pen Argyl, PA
National Provider Identifier
1003937004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS017781L
- Practice address
- 962 Pennsylvania Ave
Pen Argyl, PA 18072-9707 - Phone
- (610) 863-9212
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS017781L | PA | Primary |
Addresses
Primary practice location
962 Pennsylvania Ave
Pen Argyl, PA 18072-9707
Mailing address
962 Pennsylvania Ave
Pen Argyl, PA 18072-9707
Phone (610) 863-9212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS017781L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1003937004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "962 PENNSYLVANIA AVE",
"city": "PEN ARGYL",
"state": "PA",
"postal_code": "180729707",
"telephone_number": "610-863-9212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "962 PENNSYLVANIA AVE",
"city": "PEN ARGYL",
"state": "PA",
"postal_code": "180729707",
"telephone_number": "610-863-9212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPPERMAN",
"first_name": "THEODORE",
"middle_name": "DAVID",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS017781L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pen Argyl, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.