Individual provider Active NPI

Karen A Patenaude, D.D.S.

  • General Practice Dentistry
  • Allentown, PA
National Provider Identifier
1548288798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS024611L Issued in PA
Practice address
2030 W Tilghman St
Suite 109
Allentown, PA 18104-4354
Phone
(610) 437-5360
Fax
(610) 437-5361
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

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 DS024611L PA Primary

Addresses

Primary practice location

2030 W Tilghman St
Suite 109
Allentown, PA 18104-4354

Mailing address

2030 W Tilghman St
Suite 109
Allentown, PA 18104-4354
Phone (610) 437-5360

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
I20160112001338 PA Order and Referring Only - DentistPractitioner - Dentist 4981906617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548288798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W TILGHMAN ST",
            "address_2": "SUITE 109",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044354",
            "telephone_number": "610-437-5360",
            "fax_number": "610-437-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 W TILGHMAN ST",
            "address_2": "SUITE 109",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181044354",
            "telephone_number": "610-437-5360",
            "fax_number": "610-437-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATENAUDE",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024611L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.