Penn 1 Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS038565 Issued in PA

Legal business name

PENN 1 DENTAL

Practice address

1404 Point Breeze Ave
Philadelphia, PA 19146-4522

Phone

(215) 290-8230

NPI assigned

Jan 7, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Yefim Aranbayev, DDS

Title

Dentist/President

Phone

(215) 290-8230

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1003204553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 POINT BREEZE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464522",
            "telephone_number": "215-290-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 POINT BREEZE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191464522",
            "telephone_number": "215-290-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENN 1 DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "ARANBAYEV",
        "authorized_official_first_name": "YEFIM",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "215-290-8230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10259118000002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Peng, RPH
• Megan Lou Peng
• Tien Peng, MD
• Thomas Anthony Penko Jr., RN
• Penn
• Penn 1 Family Dental
• Penn Acupuncture Partners
• Penn Asian Healthcare Services LLC
• Penn Asian Senior Services, Inc.
• Penn Center for Rehabiliation and Care

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.