Individual provider Active NPI

Robert Eugene Nagle Jr., D.M.D

  • General Practice Dentistry
  • Harrisburg, PA
National Provider Identifier
1245403864
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS026590L Issued in PA
Practice address
227 Pine St
Harrisburg, PA 17101-1353
Phone
(717) 232-2991
Fax
(717) 232-2993
NPI assigned
Apr 3, 2008
Last updated
Apr 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 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 DS026590L PA Primary

Addresses

Primary practice location

227 Pine St
Harrisburg, PA 17101-1353

Mailing address

227 Pine St
Harrisburg, PA 17101-1353
Phone (717) 232-2991

Other identifiers 1

IdentifierTypeStateIssuer
583518OtherPAUNITED CONCORDIA

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
I20231213002245 PA Order and Referring Only - DentistPractitioner - Dentist 6800195819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS026590LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E. Nagle DMD PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1245403864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 PINE ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011353",
            "telephone_number": "717-232-2991",
            "fax_number": "717-232-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 PINE ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171011353",
            "telephone_number": "717-232-2991",
            "fax_number": "717-232-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "ROBERT",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026590L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "583518",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.