NPIMap

Organization Active NPI

David a Eichenlaub & Gary R Bodmer, Partners

  • Dental Clinic/Center
  • Lewistown, PA
National Provider Identifier
1093220105
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS017307L Issued in PA
Legal business name
DAVID A EICHENLAUB & GARY R BODMER, PARTNERS
Practice address
744 Valley St
Lewistown, PA 17044-1425
Phone
(717) 248-4896
NPI assigned
Dec 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Lavonne Kay Kirkland
Title
Office Manager
Phone
(717) 248-4896

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS017307L PA Primary
Dental Clinic/Center 261QD0000X DS021903L PA

Addresses

Primary practice location

744 Valley St
Lewistown, PA 17044-1425

Mailing address

744 Valley St
Lewistown, PA 17044-1425
Phone (717) 248-4896

Other identifiers 2

IdentifierTypeStateIssuer
1811051923OtherPAGENERAL DENTISTRY
1235293341OtherPAGENERAL DENTISTRY

National Provider Directory

National Provider Directory

Locations

744 Valley St
Lewistown, PA 17044
Phone (717) 248-4896

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1093220105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 VALLEY ST",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441425",
            "telephone_number": "717-248-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 VALLEY ST",
            "city": "LEWISTOWN",
            "state": "PA",
            "postal_code": "170441425",
            "telephone_number": "717-248-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A EICHENLAUB & GARY R BODMER, PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "LAVONNE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "717-248-4896"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS017307L",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS021903L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTISTRY",
            "identifier": "1811051923",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTISTRY",
            "identifier": "1235293341",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewistown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.