Active NPI
Ian Morton Carlis, D.M.D
- General Practice Dentistry
- Bethlehem, PA
National Provider Identifier
1407961881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS 018434 L
- Practice address
- 2597 Schoenersville Rd
Suite 301 a
Bethlehem, PA 18017-7325 - Phone
- (610) 866-6663
- NPI assigned
- Aug 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS 018434 L | PA | Primary |
Addresses
Primary practice location
2597 Schoenersville Rd
Suite 301 a
Bethlehem, PA 18017-7325
Mailing address
2597 Schoenersville Rd
Suite 301 a
Bethlehem, PA 18017-7325
Phone (610) 866-6663
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 13, 2015 through Jul 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS 018434 L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407961881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2597 SCHOENERSVILLE RD",
"address_2": "SUITE 301 A",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180177325",
"telephone_number": "610-866-6663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2597 SCHOENERSVILLE RD",
"address_2": "SUITE 301 A",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180177325",
"telephone_number": "610-866-6663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLIS",
"first_name": "IAN",
"middle_name": "MORTON",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS 018434 L",
"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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.