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General NPI Number Information
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NPI Number | 1083711295
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Entity Type | Individual
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Provider Name | WILLIAM LEONARD PADNER III D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/10/2009
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Provider Practice Location Address
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Address Line | 205 CHESTNUT STREET
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City | BERWICK
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State | PA
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Zip | 18603
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Country | US
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Telephone | 570-752-2071
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Fax | 570-752-4692
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Provider Business Mailing Address
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Address Line | 205 CHESTNUT STREET
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City | BERWICK
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State | PA
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Zip | 18603
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Country | US
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Telephone | 570-752-2071
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Fax | 570-752-4692
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS028567L
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License Number State | PA
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Legacy Identifiers
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Identifier #1
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Identifier Code | 0014331240001
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | DEPARTMENT OF PUBLIC WELF
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Identifier #2
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Identifier Code | 0014331240001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #3
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Identifier Code | 196470
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | UNITED CONCORDIA
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Identifier #4
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Identifier Code | 196470
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | BLUE SHIELD OF PA
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 0014331240001
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Identifier Type | MEDICAID
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Identifier State | PA
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Identifier Issuer |
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Identifier #2
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Identifier Code | 0014331240001
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Identifier Type | OTHER
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Identifier State | PA
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Identifier Issuer | DEPARTMENT OF PUBLIC WELF
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Identifier #3
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Identifier Code | 196470
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | BLUE SHIELD OF PA
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Identifier #4
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Identifier Code | 196470
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Identifier Type | OTHER
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Identifier State |
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Identifier Issuer | UNITED CONCORDIA
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