NPIMap

Organization Active NPI

Haverford Dental Specialists PC

Doing business as Haverford Smiles

  • Periodontics
  • Haverford, PA
National Provider Identifier
1154864791
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DSL028897L Issued in PA
Legal business name
HAVERFORD DENTAL SPECIALISTS PC
Doing business as
Haverford Smiles
Practice address
600 Haverford Rd
Ste 202
Haverford, PA 19041-1139
Phone
(610) 642-3009
NPI assigned
Nov 30, 2016
Last updated
Nov 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Authorized official

Name
Dr. John L Potter, DMD
Title
President/Owner/Periodontist
Phone
(610) 642-3009

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS029833L PA
General Practice Dentistry 1223G0001X DS039985 PA
Periodontics 1223P0300X DSL028897L PA Primary

Addresses

Primary practice location

600 Haverford Rd
Ste 202
Haverford, PA 19041-1139

Mailing address

600 Haverford Rd
Ste 202
Haverford, PA 19041-1139
Phone (610) 642-3009

Other names 1

  • Haverford Smiles Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480464000000",
    "number": "1154864791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD",
            "address_2": "STE 202",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-642-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD",
            "address_2": "STE 202",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-642-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVERFORD DENTAL SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "610-642-3009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029833L",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039985",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DSL028897L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haverford Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haverford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.