Individual provider Active NPI

Maria Salib

  • Pediatric Dentistry
  • Philadelphia, PA
National Provider Identifier
1003661745
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS044665 Issued in PA
Practice address
2301 E Allegheny Ave
Philadelphia, PA 19134-4427
Phone
(215) 282-8000
NPI assigned
Apr 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS044665 PA Primary

Addresses

Primary practice location

2301 E Allegheny Ave
Philadelphia, PA 19134-4427

Mailing address

5 Sherry Rd
East Brunswick, NJ 08816-1417
Phone (732) 289-4405

Other practice location 1

3401 N Broad St
Philadelphia, PA 19140-5103
Phone (800) 836-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703003442 PA Order and Referring Only - DentistPractitioner - Dentist 5698219491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS044665PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Once Upon a Smile Pediatric Dentistry LLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1003661745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SHERRY RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161417",
            "telephone_number": "732-289-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344427",
            "telephone_number": "215-282-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191405103",
            "country_code": "US",
            "telephone_number": "800-836-7536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALIB",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS044665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.