NPIMap

Organization Active NPI

Providence Endodontics LLC

  • Endodontics
  • Oaks, PA
National Provider Identifier
1154548857
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
PROVIDENCE ENDODONTICS LLC
Practice address
450 Cresson Blvd,
Suite 303
Oaks, PA 19456-1218
Phone
(610) 676-9030
Fax
(610) 676-9032
NPI assigned
Apr 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Meetu Ralli Kohli, D.M.DNPI 1245457944
Title
Partner
Phone
(610) 676-9030

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X PA Primary

Addresses

Primary practice location

450 Cresson Blvd,
Suite 303
Oaks, PA 19456-1218

Mailing address

450 Cresson Blvd,
Suite 303, P.O.Box 1218
Oaks, PA 19456-1218
Phone (610) 676-9030

National Provider Directory

National Provider Directory

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": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154548857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CRESSON BLVD,",
            "address_2": "SUITE 303, P.O.BOX 1218",
            "city": "OAKS",
            "state": "PA",
            "postal_code": "194561218",
            "telephone_number": "610-676-9030",
            "fax_number": "610-676-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CRESSON BLVD,",
            "address_2": "SUITE 303",
            "city": "OAKS",
            "state": "PA",
            "postal_code": "194561218",
            "telephone_number": "610-676-9030",
            "fax_number": "610-676-9032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KOHLI",
        "authorized_official_first_name": "MEETU",
        "authorized_official_middle_name": "RALLI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "610-676-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oaks, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.