Individual provider Active NPI

Michael Anthony Bianchi, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Bryn Mawr, PA
National Provider Identifier
1285663534
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS023823L Issued in PA
Practice address
26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone
(610) 527-3110
Fax
(610) 520-0534
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS023823L PA Primary
Dentist 122300000X DS023823L PA

Addresses

Primary practice location

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201

Mailing address

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone (610) 527-3110

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111102000519 PA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0547220105 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penna Oral and Maxillofacial SurgeryGroup PAC ID 9830159490, 9 clinicians

Practice addresses (Care Compare)

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone (610) 527-3112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS023823LPAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC CurrentSince Nov 1, 2020 Accepting new patients
STC Pediatrics LLC CurrentSince Nov 1, 2020 Accepting new patients
Maxilla LLC Oral and Maxillofacial Surgery CurrentSince Oct 22, 2023 Accepting new patients
STC Pediatrics LLC Current Accepting new patients
Penna Oral & Maxillofacial Surgery Dentist CurrentSince Jan 1, 2002 Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 527-3110

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1285663534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103201",
            "telephone_number": "610-527-3110",
            "fax_number": "610-520-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103201",
            "telephone_number": "610-527-3110",
            "fax_number": "610-520-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCHI",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS023823L",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS023823L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.