Tender Care Pediatric Dentistry LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS030164L Issued in PA

Legal business name

TENDER CARE PEDIATRIC DENTISTRY LLC

Practice address

6583 Route 819 S
Suite1
Mount Pleasant, PA 15666-3503

Phone

(724) 542-4818

Fax

(724) 542-4828

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Beatriz De la Roche, D.M.DNPI 1942429931

Title

Owner

Phone

(724) 542-4818

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beatriz De la Roche, D.M.D

  • Pediatric Dentistry
  • Mount Pleasant, PA
  • NPI 1942429931
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1043339476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6583 ROUTE 819 S",
            "address_2": "SUITE1",
            "city": "MOUNT PLEASANT",
            "state": "PA",
            "postal_code": "156663503",
            "telephone_number": "724-542-4818",
            "fax_number": "724-542-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6583 ROUTE 819 S",
            "address_2": "SUITE1",
            "city": "MOUNT PLEASANT",
            "state": "PA",
            "postal_code": "156663503",
            "telephone_number": "724-542-4818",
            "fax_number": "724-542-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER CARE PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "DE LA ROCHE",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-542-4818",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS030164L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "000271462",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DENTAL",
            "identifier": "2443009",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000191199",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Mount Pleasant, PA
• Providers in Mount Pleasant, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.