Individual provider Active NPI

Agata Lewkowska, DMD

  • General Practice Dentistry
  • Bala Cynwyd, PA
National Provider Identifier
1063582559
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS036625 Issued in PA
Practice address
15 Presidential Blvd
Suite #303
Bala Cynwyd, PA 19004-1006
Phone
(610) 660-9510
Fax
(610) 660-9512
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS036625 PA Primary

Addresses

Primary practice location

15 Presidential Blvd
Suite #303
Bala Cynwyd, PA 19004-1006

Mailing address

15 Presidential Blvd
Suite #303
Bala Cynwyd, PA 19004-1006
Phone (610) 660-9510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS036625PAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PRESIDENTIAL BLVD",
            "address_2": "SUITE #303",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041006",
            "telephone_number": "610-660-9510",
            "fax_number": "610-660-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PRESIDENTIAL BLVD",
            "address_2": "SUITE #303",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041006",
            "telephone_number": "610-660-9510",
            "fax_number": "610-660-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWKOWSKA",
        "first_name": "AGATA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.