NPIMap

Organization Active NPI

Collingdale Dental Associates

  • General Practice Dentistry
  • Collingdale, PA
National Provider Identifier
1124521646
Registry record updated Mar 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS038564 Issued in PA
Legal business name
COLLINGDALE DENTAL ASSOCIATES
Practice address
224 Clifton Ave
Collingdale, PA 19023-3712
Phone
(610) 583-3454
NPI assigned
Mar 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2018

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

Authorized official

Name
Dr. Aakash C Mudaliar, DMDNPI 1366964884
Title
Vice President
Phone
(570) 309-8223

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DS038564 PA Primary
Dental Clinic/Center 261QD0000X DS041461 PA

Addresses

Primary practice location

224 Clifton Ave
Collingdale, PA 19023-3712

Mailing address

224 Clifton Ave
Collingdale, PA 19023-3712
Phone (610) 583-3454

Other identifiers 2

IdentifierTypeStateIssuer
DS041461OtherPAPENNSYLVANIA STATE BOARD OF DENTISTRY
DS038564OtherPAPENNSYLVANIA STATE BOARD OF DENTISTRY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1520726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520726400000",
    "number": "1124521646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CLIFTON AVE",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190233712",
            "telephone_number": "610-583-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CLIFTON AVE",
            "city": "COLLINGDALE",
            "state": "PA",
            "postal_code": "190233712",
            "telephone_number": "610-583-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINGDALE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-11",
        "last_updated": "2018-03-11",
        "status": "A",
        "authorized_official_last_name": "MUDALIAR",
        "authorized_official_first_name": "AAKASH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "570-309-8223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038564",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS041461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF DENTISTRY",
            "identifier": "DS041461",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF DENTISTRY",
            "identifier": "DS038564",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2018; 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.