Individual provider Active NPI

Michele Ann Pisano-Marsh, DMD

  • General Practice Dentistry
  • Allentown, PA
National Provider Identifier
1780722777
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS026847-L Issued in PA
Practice address
3055 College Heights Blvd
Allentown, PA 18104
Phone
(610) 432-8037
Fax
(610) 865-1975
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS026847L PA
General Practice Dentistry 1223G0001X DS026847-L PA Primary

Addresses

Primary practice location

3055 College Heights Blvd
Allentown, PA 18104

Mailing address

3055 College Heights Blvd
Allentown, PA 18104
Phone (610) 432-8037

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
I20240212003110 PA Practitioner - Dentist 1456662006 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS026847-LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2024 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

2100 Mack Blvd
Allentown, PA 18103
Phone (484) 224-1892

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

Organizations & group practices 4

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1780722777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 COLLEGE HEIGHTS BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-432-8037",
            "fax_number": "610-865-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 COLLEGE HEIGHTS BLVD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-432-8037",
            "fax_number": "610-865-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISANO-MARSH",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026847L",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026847-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.