Individual provider Active NPI

Harold L Middleberg, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
National Provider Identifier
1356391684
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS025198-L Issued in PA
Practice address
2137 Welsh Road
Suite 1B
Philadelphia, PA 19115
Phone
(215) 676-7846
Fax
(215) 676-9384
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS025198-L PA Primary

Addresses

Primary practice location

2137 Welsh Road
Suite 1B
Philadelphia, PA 19115

Mailing address

2137 Welsh Road
Suite 1B
Philadelphia, PA 19115
Phone (215) 676-7846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS025198-LPAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Myorthos Pennsylvania Orthodontics PC Orthodontics and Dentofacial Orthopedics PastSince Nov 24, 2024 Accepting new patients
Orthodontics Limited PC Dentist Past Accepting new patients

Organizations & group practices 2

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1356391684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 WELSH ROAD",
            "address_2": "SUITE 1B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-676-7846",
            "fax_number": "215-676-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 WELSH ROAD",
            "address_2": "SUITE 1B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19115",
            "telephone_number": "215-676-7846",
            "fax_number": "215-676-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBERG",
        "first_name": "HAROLD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS025198-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.