1871799841 NPI number — STEPHEN R. GSCHREY, DMD

Table of content: (NPI 1871799841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871799841 NPI number — STEPHEN R. GSCHREY, DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEPHEN R. GSCHREY, DMD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAGLYOS DENTAL CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871799841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2551 BAGLYOS CIRCLE
Provider Second Line Business Mailing Address:
SUITE A-12
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18020-8042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-691-3050
Provider Business Mailing Address Fax Number:
610-691-7950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2551 BAGLYOS CIRCLE
Provider Second Line Business Practice Location Address:
SUITE A-12
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18020-8042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-691-3050
Provider Business Practice Location Address Fax Number:
610-691-7950
Provider Enumeration Date:
06/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GSCHREY
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
ROY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-691-3050

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DX001741 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DX001741 . This is a "STATE LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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