Organization Active NPI

Abdelkader Family Dentistry

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1104384155
Registry record updated Mar 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ABDELKADER FAMILY DENTISTRY
Practice address
358 E Wyoming Ave
Philadelphia, PA 19120-4435
Phone
(215) 324-1746
Fax
(215) 324-5557
NPI assigned
Mar 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2019

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

Authorized official

Name
Dr. Ahmed Abdelkader, DDSNPI 1437212115
Title
Dentist
Phone
(215) 324-1746

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: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

358 E Wyoming Ave
Philadelphia, PA 19120-4435

Mailing address

358 E Wyoming Ave
Philadelphia, PA 19120-4435
Phone (215) 324-1746

Other identifiers 2

IdentifierTypeStateIssuer
1028562350006MedicaidPA
0016789780001MedicaidPA

National Provider Directory

National Provider Directory

Locations

358 E Wyoming Ave
Philadelphia, PA 19120
Phone (215) 324-1746

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": "1552003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1104384155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 E WYOMING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191204435",
            "telephone_number": "215-324-1746",
            "fax_number": "215-324-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 E WYOMING AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191204435",
            "telephone_number": "215-324-1746",
            "fax_number": "215-324-5557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABDELKADER FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-08",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "ABDELKADER",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-324-1746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1028562350006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016789780001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2019; 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.