Bernard David Servagno, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DS025898-L Issued in PA

Practice address

821 Delaware Ave
Fountain Hill, PA 18015-1179

Phone

(610) 882-9910

Fax

(610) 882-1747

NPI assigned

Jul 27, 2006

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

Other identifiers 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942224555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 DELAWARE AVE",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151179",
            "telephone_number": "610-882-9910",
            "fax_number": "610-882-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 DELAWARE AVE",
            "city": "FOUNTAIN HILL",
            "state": "PA",
            "postal_code": "180151179",
            "telephone_number": "610-882-9910",
            "fax_number": "610-882-1747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVAGNO",
        "first_name": "BERNARD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS025898-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAT'L SUPPLIER",
            "identifier": "4652440001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "DS025898-L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jodi L. Schucker, M.D.
• Emily Anne Schwalm, BSN, RN, CPN
• Dara McLean Schwartz, MA, MED
• Amy D. Scott, CRNP
• Carly Sedlock, M.D.
• Daryn Jeanne Short
• Loveleen Kaur Sidhu, MD
• Kim W Silver
• Gurshawn Singh, M.D.
• Saran Taj Singh, MD, MS ED

• Prosthodontics in Fountain Hill, PA
• Providers in Fountain Hill, PA by specialty
• Prosthodontics in Pennsylvania

• 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.