Individual provider Active NPI

Bettina T. McBeth, DMD

  • General Practice Dentistry
  • Gardners, PA
National Provider Identifier
1083737274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS022400L Issued in PA
Practice address
3375 Carlisle Rd
Gardners, PA 17324-9603
Phone
(717) 677-7169
Fax
(717) 677-4069
NPI assigned
Apr 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X DS022400L PA Primary

Addresses

Primary practice location

3375 Carlisle Rd
Gardners, PA 17324-9603

Mailing address

3375 Carlisle Rd
Gardners, PA 17324-9603
Phone (717) 677-7169

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
I20160725000421 PA Order and Referring Only - DentistPractitioner - Dentist 0749573004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS022400LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083737274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 CARLISLE RD",
            "city": "GARDNERS",
            "state": "PA",
            "postal_code": "173249603",
            "telephone_number": "717-677-7169",
            "fax_number": "717-677-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 CARLISLE RD",
            "city": "GARDNERS",
            "state": "PA",
            "postal_code": "173249603",
            "telephone_number": "717-677-7169",
            "fax_number": "717-677-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBETH",
        "first_name": "BETTINA",
        "middle_name": "T.",
        "name_prefix": "Ms.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022400L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardners, PA

Sources for this page

Verify at the official NPI Registry.