Individual provider Active NPI

Amanda Stegeman Sonntag, DDS

  • Dentist
  • Wyomissing, PA
National Provider Identifier
1477936243
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS040303 Issued in PA
Practice address
1286 Penn Ave
Wyomissing, PA 19610-2130
Phone
(610) 816-6306
Fax
(610) 372-3998
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040303 PA Primary

Addresses

Primary practice location

1286 Penn Ave
Wyomissing, PA 19610-2130

Mailing address

1286 Penn Ave
Wyomissing, PA 19610-2130
Phone (610) 816-6306

Other names 1

  • Amanda Brogan Stegeman Former name

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
I20170112000911 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7416239108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS040303PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Dental LLC Current Accepting new patients
Wyomissing Dental Associates Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1477936243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102130",
            "telephone_number": "610-816-6306",
            "fax_number": "610-372-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 PENN AVE",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102130",
            "telephone_number": "610-816-6306",
            "fax_number": "610-372-3998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONNTAG",
        "first_name": "AMANDA",
        "middle_name": "STEGEMAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "STEGEMAN",
            "middle_name": "BROGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.