Easy Dental PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EASY DENTAL PC

Practice address

5616 Germantown Ave
Philadelphia, PA 19144-2228

Phone

(267) 335-2181

Fax

(215) 821-2327

NPI assigned

Aug 1, 2011

Last updated

Oct 9, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ilya Imyanitov

Title

Managing Director

Phone

(201) 637-1357

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318118400000",
    "number": "1093093585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 ADAMS AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19120",
            "telephone_number": "215-268-3344",
            "fax_number": "215-821-2327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 GERMANTOWN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442228",
            "telephone_number": "267-335-2181",
            "fax_number": "215-821-2327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-10-09",
        "status": "A",
        "authorized_official_last_name": "IMYANITOV",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "201-637-1357",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Easton, CRNP
• Eastwick Family Services
• Stephanie Elizabeth Eastwick, CRNP
• Easy Care Health Care LLC
• Easy Dental LLC
• Easy Homecare Inc
• Easy Meals Inc
• Easy Ride Non Emergency Transportation LLC
• Easy Stride Pain & Injury Center, PC
• Gregory Darryl Eatmon Sr.

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2011; 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.