NPIMap

Organization Active NPI

Shari T. Leavitt, DMD, PC

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1205138088
Registry record updated Nov 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-025799-L Issued in PA
Legal business name
SHARI T. LEAVITT, DMD, PC
Practice address
3901 Market St
Box 1936
Philadelphia, PA 19104-3133
Phone
(215) 662-1030
Fax
(215) 662-1015
NPI assigned
Nov 29, 2010
Last updated
Nov 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2010

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

Authorized official

Name
Dr. Shari Tara Leavitt, DMDNPI 1508076332
Title
Dentist/President
Phone
(215) 662-1030

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 Dentistry 1223G0001X DS-025799-L PA Primary

Addresses

Primary practice location

3901 Market St
Box 1936
Philadelphia, PA 19104-3133

Mailing address

3901 Market St
Box 1936
Philadelphia, PA 19104-3133
Phone (215) 662-1030

Other names 1

  • University Square Dental Associates Other name

National Provider Directory

National Provider Directory

Locations

3901 Market St
Ste 1936
Philadelphia, PA 19104
Phone (215) 662-1030

Practitioners & affiliated clinicians

Practitioners 2

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": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1205138088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MARKET ST",
            "address_2": "BOX 1936",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043133",
            "telephone_number": "215-662-1030",
            "fax_number": "215-662-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MARKET ST",
            "address_2": "BOX 1936",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191043133",
            "telephone_number": "215-662-1030",
            "fax_number": "215-662-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARI T. LEAVITT, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "LEAVITT",
        "authorized_official_first_name": "SHARI",
        "authorized_official_middle_name": "TARA",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "215-662-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-025799-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Square Dental Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 29, 2010; 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.