Premiere Dental of Philadelphia

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PREMIERE DENTAL OF PHILADELPHIA

Practice address

5542 Ridge Ave
Philadelphia, PA 19128-2726

Phone

(407) 463-1565

NPI assigned

Dec 11, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Alon Bekerman, DMD

Title

General Dentist/ Owner

Phone

(407) 463-1565

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1053959940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282726",
            "telephone_number": "407-463-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5542 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282726",
            "telephone_number": "407-463-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE DENTAL OF PHILADELPHIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "BEKERMAN",
        "authorized_official_first_name": "ALON",
        "authorized_official_title_or_position": "GENERAL DENTIST/ OWNER",
        "authorized_official_telephone_number": "407-463-1565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.