Individual provider Active NPI

Conrad Lee Lentz

  • Dermatology Physician
  • Bethlehem, PA
National Provider Identifier
1790043826
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD027795L Issued in PA
Practice address
125 W. Langhorne Ave
Bethlehem, PA 18017
Phone
(610) 867-3229
NPI assigned
Apr 26, 2012
Last updated
Apr 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD027795L PA Primary

Addresses

Primary practice location

125 W. Langhorne Ave
Bethlehem, PA 18017

Mailing address

125 W. Langhorne Ave
Bethlehem, PA 18017
Phone (610) 867-3229

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MD027795LPAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1790043826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 W. LANGHORNE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18017",
            "telephone_number": "610-867-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W. LANGHORNE AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18017",
            "telephone_number": "610-867-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LENTZ",
        "first_name": "CONRAD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD027795L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.