Individual provider Active NPI

John William Klopfer Jr., D.D.S.

  • General Practice Dentistry
  • East Berlin, PA
National Provider Identifier
1104001437
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS021955L Issued in PA
Practice address
113 Harrisburg St
East Berlin, PA 17316-8815
Phone
(717) 259-9612
Fax
(717) 259-0534
NPI assigned
Jan 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 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 DS021955L PA Primary

Addresses

Primary practice location

113 Harrisburg St
East Berlin, PA 17316-8815

Mailing address

113 Harrisburg St
P.O.Box 648
East Berlin, PA 17316-8815
Phone (717) 259-9612

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
I20160812001649 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315231339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS021955LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1199577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1104001437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HARRISBURG ST",
            "address_2": "P.O.BOX 648",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173168815",
            "telephone_number": "717-259-9612",
            "fax_number": "717-259-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HARRISBURG ST",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173168815",
            "telephone_number": "717-259-9612",
            "fax_number": "717-259-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOPFER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-06",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS021955L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Berlin, PA

Sources for this page

Verify at the official NPI Registry.