NPIMap

Organization Active NPI

Adelphia Dental Management LLC

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1043696875
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
122300000X Issued in PA
Legal business name
ADELPHIA DENTAL MANAGEMENT LLC
Practice address
10050 Roosevelt Blvd
Philadelphia, PA 19116-3965
Phone
(215) 277-2177
Fax
(610) 340-9060
NPI assigned
Aug 4, 2015
Last updated
Aug 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Dr. David Williams
Title
Consultant
Phone
(610) 619-0061

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 122300000X PA Primary
General Practice Dentistry 1223G0001X 1223G0001X PA

Addresses

Primary practice location

10050 Roosevelt Blvd
Philadelphia, PA 19116-3965

Mailing address

10050 Roosevelt Blvd
Philadelphia, PA 19116-3965
Phone (215) 277-2177

National Provider Directory

National Provider Directory
Tax ID family
Adelphia Dental Management2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1043696875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10050 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163965",
            "telephone_number": "215-277-2177",
            "fax_number": "610-340-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163965",
            "telephone_number": "215-277-2177",
            "fax_number": "610-340-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADELPHIA DENTAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "610-619-0061",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "122300000X",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "1223G0001X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.