Individual provider Active NPI

Michelle Lynne Bernreuther, DMD

  • General Practice Dentistry
  • Bethlehem, PA
National Provider Identifier
1063606903
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037446 Issued in PA
Practice address
240 Union Station PLZ
Bethlehem, PA 18015-1281
Phone
(610) 954-2465
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS037446 PA Primary

Addresses

Primary practice location

240 Union Station PLZ
Bethlehem, PA 18015-1281

Mailing address

4503 Hanoverville Rd
Bethlehem, PA 18020-9463

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
I20150504000975 PA Order and Referring Only - DentistPractitioner - Dentist 7911226527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS037446PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222041600000",
    "number": "1063606903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4503 HANOVERVILLE RD",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180209463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 UNION STATION PLZ",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151281",
            "telephone_number": "610-954-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNREUTHER",
        "first_name": "MICHELLE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2008-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.