Individual provider Active NPI

Wayne J Saunders, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bethlehem, PA
National Provider Identifier
1588603476
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS030506L Issued in PA
Practice address
1521 8TH Ave
1St Floor
Bethlehem, PA 18018-1893
Phone
(610) 865-8077
Fax
(610) 865-8112
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS030506L PA Primary

Addresses

Primary practice location

1521 8TH Ave
1St Floor
Bethlehem, PA 18018-1893

Mailing address

1521 8TH Ave
1St Floor
Bethlehem, PA 18018-1893
Phone (610) 865-8077

Other identifiers 1

IdentifierTypeStateIssuer
101493260MedicaidPA

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
I20031111000828 PA Practitioner - Oral Surgery 8820901143 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. CurrentSince Jun 15, 2002 Accepting new patients
St Luke'S Physician Group Inc CurrentSince Jun 15, 2002 Accepting new patients
St. Luke'S Physician Group, Inc. Current Accepting new patients

Locations

1530 8th Ave
Ste 200
Bethlehem, PA 18018
Phone (610) 861-8007

1521 8th Ave
Fl 1
Bethlehem, PA 18018

1530 8th Ave
Fl 2
Bethlehem, PA 18018
Phone (484) 526-7810

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 3

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288137600000",
    "number": "1588603476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE",
            "address_2": "1ST FLOOR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181893",
            "telephone_number": "610-865-8077",
            "fax_number": "610-865-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 8TH AVE",
            "address_2": "1ST FLOOR",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180181893",
            "telephone_number": "610-865-8077",
            "fax_number": "610-865-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "WAYNE",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2010-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS030506L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101493260",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.