Azure Rose Pelberg, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036506 Issued in PA

Practice address

1620 S Broad St
Lansdale, PA 19446-5422

Phone

(215) 616-0609

Fax

(215) 616-0643

NPI assigned

Sep 15, 2006

Last updated

Jul 1, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• All Smiles Family Dentistry

  • General Practice Dentistry
  • Lansdale, PA
  • NPI 1881077212
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1053417469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465422",
            "telephone_number": "215-616-0609",
            "fax_number": "215-616-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465422",
            "telephone_number": "215-616-0609",
            "fax_number": "215-616-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELBERG",
        "first_name": "AZURE",
        "middle_name": "ROSE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Patrick, DPT
• Paul J Suscavage OD (Family Vision)
• Taylor Pavan
• Megan Payne, PA
• Peak You LLC
• Penn Gardens Ads LLC (Penn Gardens Adult Day Center)
• Anna Penning, DDS
• Pennsylvania CVS Pharmacy LLC (CVS Pharmacy 01379)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #00338)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #02523)

• General Practice Dentistry in Lansdale, PA
• Providers in Lansdale, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.