Healthcare Provider Details

I. General information

NPI: 1174685291
Provider Name (Legal Business Name): MICHAEL ALFRED LEMPER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 BALTIMORE PIKE
CHADDS FORD PA
19317-9304
US

IV. Provider business mailing address

108 BLACKBURN DR
NOTTINGHAM PA
19362-9632
US

V. Phone/Fax

Practice location:
  • Phone: 610-388-2131
  • Fax:
Mailing address:
  • Phone: 215-868-9510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS035797
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number13822
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier101486210
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: