NPIMap

Organization Active NPI

9TH Street Dental Center PC

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1134584899
Registry record updated Dec 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-030933-L Issued in PA
Legal business name
9TH STREET DENTAL CENTER PC
Practice address
821 S 9TH St
Philadelphia, PA 19147-2822
Phone
(215) 629-0599
Fax
(215) 629-0596
NPI assigned
Dec 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2015

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

Authorized official

Name
Terrence T Fan, DMDNPI 1205931755
Title
Owner
Phone
(215) 629-0596

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS-030933-L PA Primary

Addresses

Primary practice location

821 S 9TH St
Philadelphia, PA 19147-2822

Mailing address

821 S 9TH St
Philadelphia, PA 19147-2822
Phone (215) 629-0599

National Provider Directory

National Provider Directory

Locations

821 S 9th St
Philadelphia, PA 19147
Phone (215) 629-0599

Practitioners & affiliated clinicians

Practitioners 2

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": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1134584899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472822",
            "telephone_number": "215-629-0599",
            "fax_number": "215-629-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191472822",
            "telephone_number": "215-629-0599",
            "fax_number": "215-629-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "9TH STREET DENTAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "FAN",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-629-0596",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-030933-L",
            "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 Dec 23, 2015; 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.