Mark Alexander Antonis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

023503 Issued in PA

Practice address

1333 Easton Ave
Bethlehem, PA 18018

Phone

(610) 866-5391

Fax

(610) 866-5421

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark Antonis DDS, LLC

  • Dental Clinic/Center
  • Bethlehem, PA
  • NPI 1316555048
  NPD Authorized official
• Dental Professionals of Pennsylvania, P.C.

  • General Practice Dentistry
  • Bethlehem, PA
  • NPI 1255044749
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972642270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18018",
            "telephone_number": "610-866-5391",
            "fax_number": "610-866-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 EASTON AVE",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "18018",
            "telephone_number": "610-866-5391",
            "fax_number": "610-866-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIS",
        "first_name": "MARK",
        "middle_name": "ALEXANDER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "023503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samina Anthony, RN
• Shawn Marie Anthony
• Karina Antigua, M.S.W.
• Marc Kervin Antoine, MD
• Barbara A Antonelli, PH.D, RN, CS
• Charles William Antonowicz, DO
• Anwari Counseling Services LLC
• Lauren Nicole Apgar, MSOTR/L
• Apollo Medical Group of Pennsylvania LLC
• Ivan Aponte Taboas, MD STUDENT

• General Practice Dentistry in Bethlehem, PA
• Providers in Bethlehem, PA by specialty
• General Practice Dentistry 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.