Individual provider Active NPI

Stephen David Ely, D.M.D., M.M.SC.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bethlehem, PA
National Provider Identifier
1891819488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS036407 Issued in PA
Practice address
1665 Valley Center Pkwy
Suite 100
Bethlehem, PA 18017-2269
Phone
(610) 691-4450
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS036407 PA Primary

Addresses

Primary practice location

1665 Valley Center Pkwy
Suite 100
Bethlehem, PA 18017-2269

Mailing address

1665 Valley Center Pkwy
Suite 100
Bethlehem, PA 18017-2269
Phone (610) 691-4450

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
DS036407PAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891819488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 VALLEY CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180172269",
            "telephone_number": "610-691-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 VALLEY CENTER PKWY",
            "address_2": "SUITE 100",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180172269",
            "telephone_number": "610-691-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "STEPHEN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.M.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS036407",
            "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 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.

Verify at the official NPI Registry.