Avenue of the Arts Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DS037251 Issued in PA

Legal business name

AVENUE OF THE ARTS DENTAL

Practice address

622 S Broad St
Philadelphia, PA 19146-1614

Phone

(215) 545-0660

Fax

(215) 545-0665

NPI assigned

Aug 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark B Hoang, DMD

Title

Ceo

Phone

(215) 545-0660

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314230400000",
    "number": "1013297779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461614",
            "telephone_number": "215-545-0660",
            "fax_number": "215-545-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461614",
            "telephone_number": "215-545-0660",
            "fax_number": "215-545-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUE OF THE ARTS DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2011-08-25",
        "status": "A",
        "authorized_official_last_name": "HOANG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-545-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Averbuch, D.O.
• Ilya Averbukh
• Tiffany Ann Averna, PA-C
• Elena F Aversa, DMD
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• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.