Active NPI
Harvey Barnard Henteleff, DMD
- Dental Anesthesiology
- Avonmore, PA
National Provider Identifier
1124054176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- DAO20937A
- Practice address
- 600 Cambria Ave
Avonmore, PA 15618-9791 - Phone
- (724) 697-4483
- Fax
- (724) 697-4485
- NPI assigned
- Jun 23, 2006
- Last updated
- Jul 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS020937L | PA | |
| Dental Anesthesiology | 1223D0004X | DAO20937A | PA | Primary |
Addresses
Primary practice location
600 Cambria Ave
Avonmore, PA 15618-9791
Mailing address
600 Cambria Ave
Avonmore, PA 15618
Phone (724) 697-4483
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160602002338 | PA | Order and Referring Only - Other (Physician) | 5496045460 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DAO20937A | PA | MD | Dentist Anesthesiologist |
| DS020937L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374451200000",
"number": "1124054176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 CAMBRIA AVE",
"city": "AVONMORE",
"state": "PA",
"postal_code": "15618",
"telephone_number": "724-697-4483",
"fax_number": "724-697-4485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 CAMBRIA AVE",
"city": "AVONMORE",
"state": "PA",
"postal_code": "156189791",
"telephone_number": "724-697-4483",
"fax_number": "724-697-4485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENTELEFF",
"first_name": "HARVEY",
"middle_name": "BARNARD",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2013-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS020937L",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "PA",
"license": "DAO20937A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avonmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.