Steven G Bishop, DDS

Individual provider Active NPI General Practice Dentistry · Berwick, PA

NPI 1699855072 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1699855072
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS018848L (PA)
Practice address
105 W 9TH St
Berwick, PA 18603-3024
Phone
(570) 752-4542
Fax
(570) 752-6806
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS018848LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Berwick Dental Arts Inc General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS018848L PA Yes

Addresses

Primary practice location

105 W 9TH St
Berwick, PA 18603-3024

Mailing address

92 Brentwood Cir
Bloomsburg, PA 17815-7739
Phone (570) 784-8037

Other identifiers

IdentifierTypeStateIssuer
0005214560001MedicaidPA
089467OtherPAUNITED CONCORDIA

Other providers in Berwick, PA

All providers in Berwick, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.