Bernard Jay Asdell, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12008287 Issued in IN

Practice address

707 N Michigan St
Ste 300
South Bend, IN 46601-1070

Phone

(574) 289-0080

Fax

(574) 287-6320

NPI assigned

Jun 10, 2005

Reactivated

Mar 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 3, 2019 through Jul 3, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1801890520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N MICHIGAN ST",
            "address_2": "SUITE 300",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-289-0080",
            "fax_number": "574-287-6320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N MICHIGAN ST",
            "address_2": "STE 300",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011070",
            "telephone_number": "574-289-0080",
            "fax_number": "574-287-6320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASDELL",
        "first_name": "BERNARD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2012-04-18",
        "deactivation_date": "2006-03-15",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12008287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100090950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Carita Arzola, FNP-BC
• Kadiia Asante, RBT
• Ascendant Orthopedic Alliance, LLC
• Ascendant Orthopedic Alliance, LLC
• Ascent Hospice LLC
• Stormy Asher
• Muhammad Shakil Aslam, MD
• Anthony Vincent Aspesi, MD
• Michael J Aspiotes
• Associated Riverbend Dentists PC

• Oral and Maxillofacial Surgery (Dentist) in South Bend, IN
• Providers in South Bend, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.