NPIMap

Organization Active NPI

Concordville Town Centre Dental

  • General Practice Dentistry
  • Glen Mills, PA
National Provider Identifier
1043538457
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS028310 Issued in PA
Legal business name
CONCORDVILLE TOWN CENTRE DENTAL
Practice address
600 Town Centre Dr
Suite 22
Glen Mills, PA 19342-3346
Phone
(610) 459-3644
Fax
(610) 459-0736
NPI assigned
May 10, 2010
Last updated
May 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Authorized official

Name
Dr. Douglas A. Filidore, DMDNPI 1093923013
Title
Owner
Phone
(610) 459-3644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS028310 PA Primary

Addresses

Primary practice location

600 Town Centre Dr
Suite 22
Glen Mills, PA 19342-3346

Mailing address

600 Town Centre Dr
Suite 22
Glen Mills, PA 19342-3346
Phone (610) 459-3644

National Provider Directory

National Provider Directory

Locations

600 Town Centre Dr
Ste 22
Glen Mills, PA 19342
Phone (610) 459-3644

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1043538457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TOWN CENTRE DR",
            "address_2": "SUITE 22",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193423346",
            "telephone_number": "610-459-3644",
            "fax_number": "610-459-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 TOWN CENTRE DR",
            "address_2": "SUITE 22",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193423346",
            "telephone_number": "610-459-3644",
            "fax_number": "610-459-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORDVILLE TOWN CENTRE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "FILIDORE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-459-3644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS028310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Mills, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.