Madeline Jane Kepner
Individual provider Active NPI Dentist · Elverson, PA
NPI 1003592668 · NPPES record last updated Jul 24, 2024
Key facts
- NPI
- 1003592668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DS044818 (PA)
- Practice address
- 935 Heritage Dr
Elverson, PA 19520-9324 - Phone
- (610) 286-0312
- NPI assigned
- Jun 27, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS044818 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Dentistry- Dr. Yooson Kim, LLC | Current |
Accepting new patients |
Locations
935 Heritage Dr
Elverson, PA 19520
Phone (610) 286-0312
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DS044818 | PA | Yes |
Addresses
Primary practice location
935 Heritage Dr
Elverson, PA 19520-9324
Mailing address
345 E 24TH St
New York, NY 10010-4020
Phone (212) 998-9800
Other providers in Elverson, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.