DR. GARY WARNER SELDOMRIDGE DMD NPI 1568432870

NPI Information

NPI: 1568432870
Provider Name: DR. GARY WARNER SELDOMRIDGE, DMD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
190 GOOD DR.
LANCASTER, PA
ZIP 17603
Phone: (717) 394-3033
Get Directions

DR. Gary Warner Seldomridge, DMD is an oral and maxillofacial surgery dentist in Lancaster, PA. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Gary Warner Seldomridge, DMD NPI is 1568432870. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

190 GOOD DR.
LANCASTER, PA
ZIP 17603
Phone: (717) 394-3033
Fax: (717) 390-2641

The NPI 1568432870 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 1/26/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	DS026049L	PENNSYLVANIA	Yes
2	1223P0106X	Dentist	Oral and Maxillofacial Pathology	DS026049L	PENNSYLVANIA	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DS026049L	OTHER	PENNSYLVANIA	DENTAL LICENSE
2	T30033	MEDICARE UPIN	PENNSYLVANIA
3	1730915	MEDICAID	PENNSYLVANIA
4	32271	OTHER	PENNSYLVANIA	BLUE SHIELD
5	187755EBF	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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