Individual provider Active NPI

Michael Joseph Terrery, D.M.D

  • Dentist
  • Bartonsville, PA
National Provider Identifier
1033216486
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS028943-L Issued in PA
Practice address
14 Fountain CT
Bartonsville, PA 18321-9401
Phone
(570) 629-1300
Fax
(570) 629-4300
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS028943-L PA Primary

Addresses

Primary practice location

14 Fountain CT
Bartonsville, PA 18321-9401

Mailing address

14 Fountain CT.
Bartonsville, PA 18321
Phone (570) 629-1300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150504001490 PA Order and Referring Only - DentistPractitioner - Dentist 2365761988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS028943-LPAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033216486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FOUNTAIN CT.",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "18321",
            "telephone_number": "570-629-1300",
            "fax_number": "570-629-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FOUNTAIN CT",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "183219401",
            "telephone_number": "570-629-1300",
            "fax_number": "570-629-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRERY",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS028943-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartonsville, PA

Sources for this page

Verify at the official NPI Registry.