Active NPI
Patricia Anne Wardius, DMD
- General Practice Dentistry
- Boothwyn, PA
National Provider Identifier
1194928655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS036537
- Practice address
- 3129 Naamans Creek Road
Boothwyn, PA 19061 - Phone
- (610) 494-3166
- Fax
- (610) 494-2840
- NPI assigned
- Jun 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS036537 | PA | Primary |
Addresses
Primary practice location
3129 Naamans Creek Road
Boothwyn, PA 19061
Mailing address
3129 Naamans Creek Road
Boothwyn, PA 19061
Phone (610) 494-3166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS036537 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194928655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3129 NAAMANS CREEK ROAD",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "610-494-3166",
"fax_number": "610-494-2840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3129 NAAMANS CREEK ROAD",
"city": "BOOTHWYN",
"state": "PA",
"postal_code": "19061",
"telephone_number": "610-494-3166",
"fax_number": "610-494-2840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDIUS",
"first_name": "PATRICIA",
"middle_name": "ANNE",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS036537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boothwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.