Individual provider Active NPI

Ronald R Strisofsky Jr., DDS

  • Dentist
  • Bethlehem, PA
National Provider Identifier
1639358542
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS027404L Issued in PA
Practice address
3835 Green Pond Rd
Northampton Community College
Bethlehem, PA 18020
Phone
(610) 861-5441
Fax
(610) 861-4139
NPI assigned
Oct 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS027404L PA Primary

Addresses

Primary practice location

3835 Green Pond Rd
Northampton Community College
Bethlehem, PA 18020

Mailing address

3835 Green Pond Rd
Northampton Community College
Bethlehem, PA 18020
Phone (610) 861-5441

Other identifiers 2

IdentifierTypeStateIssuer
77595OtherMED PLUS
0006453OtherAMERIHEALTH MERCY

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
I20150707000120 PA Order and Referring Only - DentistPractitioner - Dentist 7618289570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS027404LPAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1639358542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 GREEN POND RD",
            "address_2": "NORTHAMPTON COMMUNITY COLLEGE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18020",
            "telephone_number": "610-861-5441",
            "fax_number": "610-861-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 GREEN POND RD",
            "address_2": "NORTHAMPTON COMMUNITY COLLEGE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18020",
            "telephone_number": "610-861-5441",
            "fax_number": "610-861-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRISOFSKY",
        "first_name": "RONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS027404L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED PLUS",
            "identifier": "77595",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "0006453",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.