Active NPI
Alexandra Ould Betlyon, D.M.D.
- Dentist
- Mill Hall, PA
National Provider Identifier
1861602997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS029410R
- Practice address
- 266 Hogan Blvd
Suite 6
Mill Hall, PA 17751-1928 - Phone
- (570) 748-5552
- NPI assigned
- May 24, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS029410R | PA | Primary |
Addresses
Primary practice location
266 Hogan Blvd
Suite 6
Mill Hall, PA 17751-1928
Mailing address
1243 Haymaker Rd
State College, PA 16801-6944
Phone (814) 861-8288
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS029410R | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861602997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1243 HAYMAKER RD",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168016944",
"telephone_number": "814-861-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 HOGAN BLVD",
"address_2": "SUITE 6",
"city": "MILL HALL",
"state": "PA",
"postal_code": "177511928",
"telephone_number": "570-748-5552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETLYON",
"first_name": "ALEXANDRA",
"middle_name": "OULD",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS029410R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Hall, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.