Cobblestone Kids Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS036787 Issued in PA

Legal business name

COBBLESTONE KIDS PEDIATRIC DENTISTRY

Practice address

1352 South St
C5
Philadelphia, PA 19147-1858

Phone

(215) 913-3615

NPI assigned

Nov 1, 2010

Organization subpart

No

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

Authorized official

Name

Dr. George Thomas Lynch IV, D.M.D.

Title

Pediatric Dentist

Phone

(215) 913-3615

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1093015406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WASHINGTON AVE",
            "address_2": "VILLA 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191473839",
            "telephone_number": "215-913-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 SOUTH ST",
            "address_2": "C5",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471858",
            "telephone_number": "215-913-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE KIDS PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "215-913-3615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS036787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Cobb
• Ryan Cobb, M.D.
• Tito Cobb
• Alphonse Karl Cobbina
• Julia Scott Cobble, RDN, CPT
• Cobbs Creek Medical Associates,P.C
• Julien Cobert, MD
• Marjorie Elizabeth Cobin
• Marla Ruth Cobin, PH.D., L.C.S.W.
• Ailish Cameron Coblentz, MBBS

• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.