Michael D Passmore, DMD
Individual provider Active NPI General Practice Dentistry · Mount Wolf, PA
NPI 1205975596 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205975596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS036559 (PA)
- Practice address
- 5100 Board Rd
Mount Wolf, PA 17347-9559 - Phone
- (717) 266-6694
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150226002011 | PA | Order and Referring Only - Dentist |
2668798133 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS036559 | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS036559 | PA | Yes |
Addresses
Primary practice location
5100 Board Rd
Mount Wolf, PA 17347-9559
Mailing address
5100 Board Rd
Mount Wolf, PA 17347-9559
Phone (717) 266-6694
Other providers in Mount Wolf, PA
- Samuel Means
- Bethany Robin Miller
- Mount Wolf Medical Center PC
- Kayla Muff
- Katelyn Parisi
- Jennifer Patti
- Emily McCall Payne
- Ashley Lynn Perigo
- Jennifer Lee Price
- Kimberley Alyce Robinson
All providers in Mount Wolf, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.