Active NPI
James Brian Straka, DMD
- Periodontics
- Bethlehem, PA
National Provider Identifier
1386796373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DSO28985L
- Practice address
- 3005 Brodhead Rd
Suite 184
Bethlehem, PA 18020-9201 - Phone
- (610) 814-6277
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DSO28985L | PA | Primary |
Addresses
Primary practice location
3005 Brodhead Rd
Suite 184
Bethlehem, PA 18020-9201
Mailing address
3005 Brodhead Rd
Suite 184
Bethlehem, PA 18020-9201
Phone (610) 814-6277
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160215000795 | PA | Order and Referring Only - Oral Surgery | 9931403730 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DSO28985L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386796373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3005 BRODHEAD RD",
"address_2": "SUITE 184",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180209201",
"telephone_number": "610-814-6277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3005 BRODHEAD RD",
"address_2": "SUITE 184",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180209201",
"telephone_number": "610-814-6277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRAKA",
"first_name": "JAMES",
"middle_name": "BRIAN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DSO28985L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; 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.