NPIMap

Organization Active NPI

Mayfair Dental Center

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1003289810
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS039940 Issued in PA
Legal business name
MAYFAIR DENTAL CENTER
Practice address
4612 Frankford Ave
Unit 10
Philadelphia, PA 19124-5804
Phone
(215) 333-8100
Fax
(215) 333-8111
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Authorized official

Name
Mr. Robert Zlat
Title
Manager
Phone
(215) 333-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DS039940 PA Primary

Addresses

Primary practice location

4612 Frankford Ave
Unit 10
Philadelphia, PA 19124-5804

Mailing address

4612 Frankford Ave
Unit 10
Philadelphia, PA 19124-5804
Phone (215) 333-8100

National Provider Directory

National Provider Directory
Tax ID family
Mayfair Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4612 Frankford Ave
Unit 10
Philadelphia, PA 19124
Phone (215) 333-8100

NPI Registry JSON

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446508800000",
    "number": "1003289810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 FRANKFORD AVE",
            "address_2": "UNIT 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245804",
            "telephone_number": "215-333-8100",
            "fax_number": "215-333-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 FRANKFORD AVE",
            "address_2": "UNIT 10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191245804",
            "telephone_number": "215-333-8100",
            "fax_number": "215-333-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFAIR DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A",
        "authorized_official_last_name": "ZLAT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-333-8100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.