Alexander Thomas Berarducci, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS042867 Issued in PA

Practice address

510 Town Centre Dr
Johnstown, PA 15904-2841

Phone

(814) 266-5141

NPI assigned

Jul 31, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1811507262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MCGREGOR LN",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 TOWN CENTRE DR",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159042841",
            "telephone_number": "814-266-5141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERARDUCCI",
        "first_name": "ALEXANDER",
        "middle_name": "THOMAS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.