Michael a. Conrad, DDS, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DS023025L Issued in PA

Legal business name

MICHAEL A. CONRAD, DDS, PC

Practice address

770 Fetters LN
Wescosville, PA 18106-9290

Phone

(610) 398-1435

Fax

(610) 398-6278

NPI assigned

Apr 26, 2012

Last updated

Apr 26, 2012By 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

Michael Alan Conrad, DDSNPI 1891828505

Title

President

Phone

(610) 398-1435

Specialties & licenses 1

Addresses

Other names 1

• The Dentist Down the Lane Other name

Locations

Practitioners 1

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.

• Michael A. Conrad, DDS

  • General Practice Dentistry
  • Wescosville, PA
  • NPI 1891828505
  NPD (past) Authorized official

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1437417524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3243",
            "city": "WESCOSVILLE",
            "state": "PA",
            "postal_code": "181060243",
            "telephone_number": "610-398-1435",
            "fax_number": "610-398-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 FETTERS LN",
            "city": "WESCOSVILLE",
            "state": "PA",
            "postal_code": "181069290",
            "telephone_number": "610-398-1435",
            "fax_number": "610-398-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL A. CONRAD, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "CONRAD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-398-1435",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS023025L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dentist Down the Lane",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Gene W. Miller, D.O.
• Abigail Elizabeth Nessle, RDN
• Heather P. O'Donnell, M.A.
• Patricia Lasalle Nutrition LLC
• Carolyn Joanne Preston, LMT, MMT

• Dental Clinic/Center in Wescosville, PA
• Providers in Wescosville, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.