Bernard J Dormer Jr., DDS PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

MD05156 Issued in MD

Practice address

1410 S Salisbury Blvd
Suite 3
Salisbury, MD 21801-7127

Phone

(410) 749-0248

Fax

(410) 749-0292

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417977752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S SALISBURY BLVD",
            "address_2": "SUITE 3",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017127",
            "telephone_number": "410-749-0248",
            "fax_number": "410-749-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S SALISBURY BLVD",
            "address_2": "SUITE 3",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017127",
            "telephone_number": "410-749-0248",
            "fax_number": "410-749-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMER",
        "first_name": "BERNARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "MD05156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIAN",
            "identifier": "141236",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James William Donaldson, D.D.S.
• Roberto Ezequiel Donati, LCPC
• Leslie H Donnelly, ED.D
• Lia Marie Dopp, MD
• Olivia Michaela Dorman, CRNP
• Jennifer Doty, PTA
• Patrick Porter Dougherty, PHARMD
• Tamara M Dougherty, LCPC
• Dove Pointe Inc
• Dove Pointe Residential Service Inc

• Oral and Maxillofacial Surgery (Dentist) in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.