Individual provider Active NPI

Michael Tomczyk, D.D.S.

  • General Practice Dentistry
  • Bethlehem, PA
National Provider Identifier
1639205743
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037118 Issued in PA
Practice address
627 W Broad St
Bethlehem, PA 18018-5220
Phone
(732) 610-6200
NPI assigned
Feb 25, 2007
Last updated
Feb 5, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI19811 NJ
General Practice Dentistry 1223G0001X DS037118 PA Primary

Addresses

Primary practice location

627 W Broad St
Bethlehem, PA 18018-5220

Mailing address

627 W Broad St
Bethlehem, PA 18018-5220
Phone (732) 610-6200

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
I20200325000583 PA Order and Referring Only - DentistPractitioner - Dentist 5395173314

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI19811NJMDDentist
DS037118PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1639205743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 W BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185220",
            "telephone_number": "732-610-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 W BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180185220",
            "telephone_number": "732-610-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZYK",
        "first_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-25",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI19811",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.