Lydia Elizabeth Hainley, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS040842 Issued in PA

Practice address

346 York Ave
Towanda, PA 18848-2021

Phone

(570) 828-3992

NPI assigned

Jun 3, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lydia Elizabeth Civello Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Wellsboro, PA
  • NPI 1912093576
  Medicare reassignment NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Elkland, PA
  • NPI 1003913955
  NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Laporte, PA
  • NPI 1093520587
  NPD
• North Penn Comprehensive Health Services

  • Federally Qualified Health Center (FQHC)
  • Towanda, PA
  • NPI 1184357329
  NPD
• Hainley Family Dentistry

  • Dental Clinic/Center
  • Wyalusing, PA
  • NPI 1932588159
  NPD (past)

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1316395015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 W WELLSBORO ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331411",
            "telephone_number": "570-662-1945",
            "fax_number": "570-746-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 YORK AVE",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188482021",
            "telephone_number": "570-828-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINLEY",
        "first_name": "LYDIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-03",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYDIA",
            "last_name": "CIVELLO",
            "middle_name": "ELIZABETH",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Guthrie Towanda Memorial Hospital
• Guthrie Towanda Memorial Hospital
• Guthrie Towanda Memorial Hospital
• Guthrie Towanda Memorial Hospital
• Guthrie Towanda Memorial Hospital
• Francis J Hannagan, MD
• Desiree Nicole Hart, LPC
• Tiffany M Hawkins, SLP
• Caryn Henderson, CRNP
• Robert Hine

• Dentist in Towanda, PA
• Providers in Towanda, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.