NPIMap

Organization Active NPI

Children and Teen Dental Group of Pennsylvania PC

  • Pediatric Dentistry
  • Kennett Square, PA
National Provider Identifier
1124576004
Registry record updated Sep 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
CHILDREN AND TEEN DENTAL GROUP OF PENNSYLVANIA PC
Practice address
400 McFarlan Rd
Ste 200
Kennett Square, PA 19348-2477
Phone
(610) 925-5700
NPI assigned
Sep 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2016

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

Authorized official

Name
Brian Smith
Title
Cfo
Phone
(770) 231-5348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

400 McFarlan Rd
Ste 200
Kennett Square, PA 19348-2477

Mailing address

400 McFarlan Rd
Ste 200
Kennett Square, PA 19348-2477
Phone (610) 925-5700

National Provider Directory

National Provider Directory
Tax ID family
Children and Teen Dental Group of Pennsylvania3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1124576004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MCFARLAN RD",
            "address_2": "STE 200",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482477",
            "telephone_number": "610-925-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MCFARLAN RD",
            "address_2": "STE 200",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482477",
            "telephone_number": "610-925-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN AND TEEN DENTAL GROUP OF PENNSYLVANIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-231-5348"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.