NPIMap

Organization Active NPI

Smile Bright Dental

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1154717825
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS019271L Issued in PA
Legal business name
SMILE BRIGHT DENTAL
Practice address
2102 S Broad St
Philadelphia, PA 19145-3960
Phone
(267) 388-0998
Fax
(215) 689-4687
NPI assigned
Apr 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Dr. Leon Aire Wertheimer, DDS
Title
Dentist
Phone
(267) 388-0998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS019271L PA Primary

Addresses

Primary practice location

2102 S Broad St
Philadelphia, PA 19145-3960

Mailing address

2102 S Broad St
Philadelphia, PA 19145-3960
Phone (267) 388-0998

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1154717825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453960",
            "telephone_number": "267-388-0998",
            "fax_number": "215-689-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453960",
            "telephone_number": "267-388-0998",
            "fax_number": "215-689-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE BRIGHT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "WERTHEIMER",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "AIRE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "267-388-0998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019271L",
            "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 Apr 13, 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.