Northeast Pediatric Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

NORTHEAST PEDIATRIC DENTAL LLC

Doing business as

Dentistry for Children

Practice address

7122 Rising Sun Ave
Philadelphia, PA 19111-3957

Phone

(267) 809-7788

NPI assigned

Aug 22, 2021

Last updated

Aug 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Win Chin Lee, DMDNPI 1275949760

Title

Pediatric Dentist

Phone

(267) 809-7788

Specialties & licenses 1

Addresses

Other names 1

• Dentistry for Children Doing business as

Locations

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.

• Win Lee

  • Pediatric Dentistry
  • Philadelphia, PA
  • NPI 1275949760
  NPD Authorized official

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

{
    "created_epoch": "1629590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629590400000",
    "number": "1053087759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 VILLAGE SQ",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193012108",
            "telephone_number": "267-809-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7122 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113957",
            "telephone_number": "267-809-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PEDIATRIC DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-22",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "WIN",
        "authorized_official_middle_name": "CHIN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "267-809-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentistry for Children",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2021; 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.