Ingram and Daugherty Orthodontists, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS020047L Issued in PA

Legal business name

INGRAM AND DAUGHERTY ORTHODONTISTS, LLC

Practice address

710 S 12TH St
Lebanon, PA 17042-6901

Phone

(717) 274-2913

NPI assigned

Feb 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen B Ingram, DMD, CERT ORTHODONTNPI 1255842340

Title

Orthodontist

Phone

(717) 274-2913

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Stephen Bertram Ingram Jr., DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lebanon, PA
  • NPI 1255842340
  NPD (past) Authorized official
• Warren Patrick Daugherty, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lebanon, PA
  • NPI 1831600113
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396870317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S 12TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426901",
            "telephone_number": "717-274-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S 12TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426901",
            "telephone_number": "717-274-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAM AND DAUGHERTY ORTHODONTISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "717-274-2913",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, CERT ORTHODONT"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS020047L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR INGRAMS STATE LICENSE",
            "identifier": "DS020047L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane F Ilgenfritz, LCSW
• Erin Rebecca Illyes, LCSW
• Paul Impellizzeri, M.D.
• Independence Corporation (Eyeland Optical)
• Individual Empowerment Inc
• Stephen Bertram Ingram Jr., DMD
• Innovative Wellness Group LLC
• Melanie Erin Isaac, MT-BC
• Michael Jeffrey Itzkowitz, PH.D.
• Mark Jacobson, DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.