Provider Demographics
NPI:1780757443
Name:DELUMPA, BERNADETTE ANNE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:ANNE
Last Name:DELUMPA
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:BERNADETTE
Other - Middle Name:DELUMPA
Other - Last Name:FOLKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:1454 MADISON AVE W
Mailing Address - Street 2:
Mailing Address - City:IMMOKALEE
Mailing Address - State:FL
Mailing Address - Zip Code:34142-2200
Mailing Address - Country:US
Mailing Address - Phone:239-658-3000
Mailing Address - Fax:239-932-6935
Practice Address - Street 1:12655 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-4005
Practice Address - Country:US
Practice Address - Phone:239-658-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120095051223P0221X
FLHAD1121223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200367590Medicaid
IN100209840Medicaid