Individual provider Active NPI

David N Bordonaro, DMD

  • General Practice Dentistry
  • Allentown, PA
National Provider Identifier
1427179498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS023638L Issued in PA
Practice address
123 N 13TH St
Allentown, PA 18102-3758
Phone
(610) 434-9660
Fax
(610) 434-1167
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS023638L PA Primary

Addresses

Primary practice location

123 N 13TH St
Allentown, PA 18102-3758

Mailing address

123 N 13TH St
Allentown, PA 18102-3758
Phone (610) 434-9660

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160129002275 PA Order and Referring Only - DentistPractitioner - Dentist 5193028876

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS023638LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427179498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N 13TH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023758",
            "telephone_number": "610-434-9660",
            "fax_number": "610-434-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N 13TH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181023758",
            "telephone_number": "610-434-9660",
            "fax_number": "610-434-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDONARO",
        "first_name": "DAVID",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS023638L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.