NPIMap

Organization Active NPI

Lehigh Valley Suburban Dental Assoc LTD

  • Dentist
  • Allentown, PA
National Provider Identifier
1437269008
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS020511L Issued in PA
Legal business name
LEHIGH VALLEY SUBURBAN DENTAL ASSOC LTD
Practice address
1621 N Cedarcrest Blvd
Suite 117
Allentown, PA 18104
Phone
(610) 820-9900
Fax
(610) 820-9922
NPI assigned
Aug 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark B Diamond, DMDNPI 1932380656
Title
Partner Manager
Phone
(610) 820-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS017121L PA
Dentist 122300000X DS019952L PA
Dentist 122300000X DS022795L PA
Dentist 122300000X DS020511L PA Primary

Addresses

Primary practice location

1621 N Cedarcrest Blvd
Suite 117
Allentown, PA 18104

Mailing address

1621 N Cedarcrest Blvd
Suite 117
Allentown, PA 18104
Phone (610) 820-9900

Other identifiers 2

IdentifierTypeStateIssuer
10274OtherPAAETNA
414531OtherPAUNITED CONCORDIA UCCI

Other names 1

  • Suburban Dental Associates Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437269008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 N CEDARCREST BLVD",
            "address_2": "SUITE 117",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-820-9900",
            "fax_number": "610-820-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 N CEDARCREST BLVD",
            "address_2": "SUITE 117",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-820-9900",
            "fax_number": "610-820-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEHIGH VALLEY SUBURBAN DENTAL ASSOC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER MANAGER",
        "authorized_official_telephone_number": "610-820-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS017121L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS019952L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS022795L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS020511L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "10274",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA UCCI",
            "identifier": "414531",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Dental Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • 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.