Center City Periodontists, P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DS-016719-L Issued in PA

Legal business name

CENTER CITY PERIODONTISTS, P.C.

Practice address

1500 Locust St
Suite 1413
Philadelphia, PA 19102-4329

Phone

(215) 546-3700

Fax

(215) 546-0393

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carole N. Hildebrand, DDS, ME.D

Title

President

Phone

(215) 546-3700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164517140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST",
            "address_2": "SUITE 1413",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024329",
            "telephone_number": "215-546-3700",
            "fax_number": "215-546-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LOCUST ST",
            "address_2": "SUITE 1413",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191024329",
            "telephone_number": "215-546-3700",
            "fax_number": "215-546-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER CITY PERIODONTISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HILDEBRAND",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-546-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, ME.D"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS-016719-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Periodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.