Individual provider Active NPI

Fernando J Ehrhardt, D.M.D.

  • Periodontics
  • Fishkill, NY
National Provider Identifier
1912922709
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
048977-1 Issued in NY
Practice address
738 Route 9 Ste. 22
Fishkill, NY 12524
Phone
(845) 896-5151
Fax
(845) 896-0974
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 048977-1 NY Primary

Addresses

Primary practice location

738 Route 9 Ste. 22
Fishkill, NY 12524

Mailing address

738 Route 9 Ste. 22
Fishkill, NY 12524
Phone (845) 896-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150428000830 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8527387471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
048977-1NYMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1912922709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 ROUTE 9 STE. 22",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "12524",
            "telephone_number": "845-896-5151",
            "fax_number": "845-896-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 ROUTE 9 STE. 22",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "12524",
            "telephone_number": "845-896-5151",
            "fax_number": "845-896-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRHARDT",
        "first_name": "FERNANDO",
        "middle_name": "J",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NY",
            "license": "048977-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.