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NPI Code Detail

MEDICARE: DR. BERNADETTE ANNE DELUMPA DDS, MS

MEDICARE: DR. BERNADETTE ANNE DELUMPA DDS, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry12009505IN
21223P0221XPediatric DentistryHAD112FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780757443
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERNADETTE ANNE DELUMPA DDS, MS
Provider Business Mailing Address
First Line : 1454 MADISON AVE W
Second Line :
City : IMMOKALEE
State : FL
Zip : 34142-2200
Country : US
Telephone Number : 239-658-3000
Fax Number : 239-932-6935
Provider Business Practice Location Address
First Line : 12655 COLLIER BLVD
Second Line :
City : NAPLES
State : FL
Zip : 34116-4005
Country : US
Telephone Number : 239-658-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/12/2021

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