NPIMap

Organization Active NPI

Dental Professionals of Pennsylvania, P.C.

Doing business as Avenue Dental

  • General Practice Dentistry
  • Bethlehem, PA
National Provider Identifier
1255044749
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF PENNSYLVANIA, P.C.
Doing business as
Avenue Dental
Practice address
1333 Easton Ave
Bethlehem, PA 18018-2624
Phone
(610) 866-5391
NPI assigned
Dec 30, 2022
Last updated
Dec 30, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DENTAL PROFESSIONALS OF PENNSYLVANIA, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1333 Easton Ave
Bethlehem, PA 18018-2624

Mailing address

1333 Easton Ave
Bethlehem, PA 18018-2624

Other names 1

  • Avenue Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Pennsylvania PC40 organizations share this tax ID, including this one
Part of
Dental Professionals of Pennsylvania PC

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

1333 Easton Ave
Bethlehem, PA 18018
Phone (610) 866-5391

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672358400000",
    "number": "1255044749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180182624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180182624",
            "telephone_number": "610-866-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF PENNSYLVANIA, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL PROFESSIONALS OF PENNSYLVANIA, P.C.",
        "enumeration_date": "2022-12-30",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avenue Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.