Individual provider Active NPI

Michael Edward Hyduk, D.M.D.

  • Dentist
  • Bethlehem, PA
National Provider Identifier
1710275243
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038839 Issued in PA
Practice address
818 W Broad St
Bethlehem, PA 18018
Phone
(610) 691-0160
Fax
(610) 691-7316
NPI assigned
Jul 18, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS038839 PA Primary
General Practice Dentistry 1223G0001X DS038839 PA

Addresses

Primary practice location

818 W Broad St
Bethlehem, PA 18018

Mailing address

818 W. Broad St
Bethlehem, PA 18018
Phone (610) 691-0160

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
I20160219001924 PA Order and Referring Only - DentistPractitioner - Dentist 4183929748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038839PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Patrick F Adams Ddspc General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.hyduk.p10@direct.360care.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1710275243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W. BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18018",
            "telephone_number": "610-691-0160",
            "fax_number": "610-691-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W BROAD ST",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18018",
            "telephone_number": "610-691-0160",
            "fax_number": "610-691-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYDUK",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-18",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038839",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038839",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.