Active NPI
Casimir M Wolanin, DMD
- Dentist
- Havertown, PA
National Provider Identifier
1073614947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 025699
- Practice address
- 1210 Darby Rd
Havertown, PA 19083-3603 - Phone
- (610) 789-7337
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 025699 | PA | Primary |
Addresses
Primary practice location
1210 Darby Rd
Havertown, PA 19083-3603
Mailing address
1210 Darby Rd
Havertown, PA 19083-3603
Phone (610) 789-7337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2100447516 | Other | PA | DENTAL OFFICE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 025699 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reinholds LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073614947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 DARBY RD",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190833603",
"telephone_number": "610-789-7337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1210 DARBY RD",
"city": "HAVERTOWN",
"state": "PA",
"postal_code": "190833603",
"telephone_number": "610-789-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLANIN",
"first_name": "CASIMIR",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "025699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL OFFICE",
"identifier": "2100447516",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Havertown, 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.