Active NPI
Mfon-Abasi Connell-Gentle, RDH, PHDHP
- Dental Hygienist
- Philadelphia, PA
National Provider Identifier
1124590179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- PHDH001055
- Practice address
- 5201 Haverford Ave
Philadelphia, PA 19139-1401 - Phone
- (215) 471-2761
- NPI assigned
- Dec 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | PHDH001055 | PA | Primary |
Addresses
Primary practice location
5201 Haverford Ave
Philadelphia, PA 19139-1401
Mailing address
5201 Haverford Ave
Philadelphia, PA 19139-1401
Phone (215) 471-2761
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHDH001055 | PA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1124590179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5201 HAVERFORD AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191391401",
"telephone_number": "215-471-2761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5201 HAVERFORD AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191391401",
"telephone_number": "215-471-2761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL-GENTLE",
"first_name": "MFON-ABASI",
"credential": "RDH, PHDHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-31",
"last_updated": "2023-03-06",
"certification_date": "2023-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "PA",
"license": "PHDH001055",
"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 Mar 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.