NPIMap

Organization Active NPI

MDS Management, Inc.

  • General Practice Dentistry
  • Camden, NJ
National Provider Identifier
1184779985
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS 029186-L Issued in PA
Legal business name
MDS MANAGEMENT, INC.
Practice address
433 Market St Ste 102
Camden, NJ 08102-1572
Phone
(856) 963-0315
Fax
(856) 963-2369
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Dr. Natalya Kondratyeva, D.D.S.NPI 1316936479
Title
Owner
Phone
(856) 963-0315

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 029186-L PA Primary

Addresses

Primary practice location

433 Market St Ste 102
Camden, NJ 08102-1572

Mailing address

352 2ND Street Pike #396
Southampton, PA 18966
Phone (215) 745-5734

Other practice location 1

111 Lawrenceville Rd
Lawrence Township, NJ 08648-4307
Phone (609) 599-4800

Other identifiers 2

IdentifierTypeStateIssuer
864628OtherPAUNITED CONCORDIA GROUP ID
100963871-0001MedicaidPA

National Provider Directory

National Provider Directory

Locations

433 Market St
Ste 102
Camden, NJ 08102
Phone (856) 963-0315

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1184779985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 2ND STREET PIKE #396",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "18966",
            "telephone_number": "215-745-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 MARKET ST STE 102",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081021572",
            "telephone_number": "856-963-0315",
            "fax_number": "856-963-2369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Lawrenceville Rd",
            "address_purpose": "LOCATION",
            "city": "Lawrence Township",
            "state": "NJ",
            "postal_code": "086484307",
            "country_code": "US",
            "telephone_number": "609-599-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MDS MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "KONDRATYEVA",
        "authorized_official_first_name": "NATALYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-963-0315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS 029186-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA GROUP ID",
            "identifier": "864628",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100963871-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.