Individual provider Active NPI

Bruce Alan Katz, D.D.S.

  • General Practice Dentistry
  • Lancaster, PA
National Provider Identifier
1073613121
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS025254L Issued in PA
Practice address
2069 Lititz Pike
Lancaster, PA 17601-3801
Phone
(717) 560-9623
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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 DS025254L PA Primary

Addresses

Primary practice location

2069 Lititz Pike
Lancaster, PA 17601-3801

Mailing address

2069 Lititz Pike
Lancaster, PA 17601-3801
Phone (717) 560-9623

Other identifiers 1

IdentifierTypeStateIssuer
550843997OtherPAT.I.N.

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
I20150422002051 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002134020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS025254LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1073613121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2069 LITITZ PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176013801",
            "telephone_number": "717-560-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2069 LITITZ PIKE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176013801",
            "telephone_number": "717-560-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS025254L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "T.I.N.",
            "identifier": "550843997",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.