Organization Active NPI

Willowdale Family Dentistry PLLC

  • Dentist
  • Kennett Square, PA
National Provider Identifier
1073449930
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WILLOWDALE FAMILY DENTISTRY PLLC
Practice address
690 Unionville Rd
Kennett Square, PA 19348-1704
Phone
(814) 558-2731
NPI assigned
Jun 19, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Authorized official

Name
Dr. Ryan Austin, DDSNPI 1811481989
Title
Owner Dentist
Phone
(814) 558-2731

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

690 Unionville Rd
Kennett Square, PA 19348-1704

Mailing address

808 Fountain TRL
Kennett Square, PA 19348-1927
Phone (814) 558-2731

National Provider Directory

National Provider Directory

Locations

690 Unionville Rd
Kennett Square, PA 19348
Phone (610) 444-8744

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1781827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781827200000",
    "number": "1073449930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 FOUNTAIN TRL",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481927",
            "telephone_number": "814-558-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 UNIONVILLE RD",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193481704",
            "telephone_number": "814-558-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWDALE FAMILY DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-19",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "814-558-2731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.