Individual provider Active NPI

Christopher Maroon, DDS

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1114417060
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS041885 Issued in PA
Practice address
1575 N 52ND St Ste 705
Philadelphia, PA 19131
Phone
(215) 879-1777
NPI assigned
May 16, 2018
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401416605 VA
General Practice Dentistry 1223G0001X DS041885 PA Primary

Addresses

Primary practice location

1575 N 52ND St Ste 705
Philadelphia, PA 19131

Mailing address

350 N Clark St Ste 600
Chicago, IL 60654-4782
Phone (312) 274-4526

Other practice location 1

2107B Cottman Ave
Philadelphia, PA 19149-1122
Phone (215) 235-4060

Other practice location 2

5675 N Front St
Philadelphia, PA 19120-2719
Phone (215) 224-0440

Other practice location 3

400 W Allegheny Ave Ste 100
Philadelphia, PA 19133-3614
Phone (215) 291-9200

Other practice location 4

61 W Chelten Ave
Philadelphia, PA 19144-2701
Phone (215) 713-2626

Other practice location 5

1575 N 52nd St Ste 705
Philadelphia, PA 19131
Phone (215) 879-1777

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

LicenseStateTypeSpecialty
DS041885PAMDGeneral Practice Dentistry
0401416605VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Dental, LLC General Practice Past Accepting new patients
The Foleck Center General Practice Past Accepting new patients
The Foleck Center, LTD. General Practice Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1114417060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544782",
            "telephone_number": "312-274-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N 52ND ST STE 705",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19131",
            "telephone_number": "215-879-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2107B Cottman Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191491122",
            "country_code": "US",
            "telephone_number": "215-235-4060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5675 N Front St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191202719",
            "country_code": "US",
            "telephone_number": "215-224-0440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 W Allegheny Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191333614",
            "country_code": "US",
            "telephone_number": "215-291-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 W Chelten Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191442701",
            "country_code": "US",
            "telephone_number": "215-713-2626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 N 52nd St Ste 705",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19131",
            "country_code": "US",
            "telephone_number": "215-879-1777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAROON",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416605",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041885",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 2, 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.