Individual provider Active NPI

Andrew L Kanter, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Collegeville, PA
National Provider Identifier
1053341164
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS028977L Issued in PA
Practice address
555 Second Ave Ste E-100
Collegeville, PA 19426-3622
Phone
(610) 409-9660
Fax
(610) 409-9668
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS028977L PA Primary

Addresses

Primary practice location

555 Second Ave Ste E-100
Collegeville, PA 19426-3622

Mailing address

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone (610) 527-3110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627000134 PA Practitioner - Maxillofacial Surgery 2163467523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penna Oral and Maxillofacial SurgeryGroup PAC ID 9830159490, 9 clinicians

Practice addresses (Care Compare)

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3201
Phone (610) 527-3112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Penna Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Jan 1, 2002 Accepting new patients
Maxilla LLC Oral and Maxillofacial Surgery PastSince Oct 22, 2023 Accepting new patients

Locations

26 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (610) 527-3110

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1053341164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103201",
            "telephone_number": "610-527-3110",
            "fax_number": "610-520-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SECOND AVE STE E-100",
            "city": "COLLEGEVILLE",
            "state": "PA",
            "postal_code": "194263622",
            "telephone_number": "610-409-9660",
            "fax_number": "610-409-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTER",
        "first_name": "ANDREW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS028977L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collegeville, PA

Sources for this page

Verify at the official NPI Registry.