NPIMap

Organization Active NPI

Spark Orthodontics, P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bethlehem, PA
National Provider Identifier
1881924140
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS038055 Issued in PA
Legal business name
SPARK ORTHODONTICS, P.C.
Practice address
701 W Union Blvd
Suite 11
Bethlehem, PA 18018-3700
Phone
(610) 865-2777
Fax
(610) 865-1099
NPI assigned
Jan 10, 2010
Last updated
Aug 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Dr. Jason Michael Hartman, D.M.D, M.S.NPI 1356591903
Title
President/Orthodontist
Phone
(610) 865-2777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS038055 PA Primary

Addresses

Primary practice location

701 W Union Blvd
Suite 11
Bethlehem, PA 18018-3700

Mailing address

5318 Allentown Pike
Temple, PA 19560-1249
Phone (610) 865-2777

Other identifiers 1

IdentifierTypeStateIssuer
1023923970001MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Spark Orthodontics PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

701 W Union Blvd
Unit 11
Bethlehem, PA 18018
Phone (610) 334-3278

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1263081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1881924140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 ALLENTOWN PIKE",
            "city": "TEMPLE",
            "state": "PA",
            "postal_code": "195601249",
            "telephone_number": "610-865-2777",
            "fax_number": "610-929-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W UNION BLVD",
            "address_2": "SUITE 11",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180183700",
            "telephone_number": "610-865-2777",
            "fax_number": "610-865-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK ORTHODONTICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-10",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "HARTMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/ORTHODONTIST",
        "authorized_official_telephone_number": "610-865-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D, M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS038055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023923970001",
            "state": "PA"
        }
    ],
    "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 Aug 12, 2022; 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.