Individual provider Active NPI

George A Souliman, B.D.S., D.M.D

  • General Practice Dentistry
  • Haverford, PA
National Provider Identifier
1205275872
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS039840 Issued in PA
Practice address
600 Haverford Rd Ste 202
Haverford, PA 19041-1139
Phone
(610) 642-3009
Fax
(610) 642-2328
NPI assigned
Jun 17, 2013
Last updated
Jan 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS039840 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220119001568 PA Practitioner - Dentist 4385036615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emmanuel Dental Care LLC Current Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 3, 2022 Accepting new patients
Einstein Practice Plan Inc CurrentSince Jan 3, 2022 Accepting new patients
Einstein Practice Plan Inc Current Accepting new patients
Good Shepherd Dental Care PLLC CurrentSince Aug 6, 2019 Accepting new patients
Haverford Dental Specialists PC General Practice Past Accepting new patients

Locations

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

101 E Olney Ave
Ste 400
Philadelphia, PA 19120
Phone (215) 254-2630

5401 Old York Rd
Ste 5
Philadelphia, PA 19141
Phone (215) 456-6127

5501 York Rd
Philadelphia, PA 19141
Phone (215) 456-7405

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1205275872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD STE 202",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-642-3009",
            "fax_number": "610-642-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HAVERFORD RD STE 202",
            "city": "HAVERFORD",
            "state": "PA",
            "postal_code": "190411139",
            "telephone_number": "610-642-3009",
            "fax_number": "610-642-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULIMAN",
        "first_name": "GEORGE",
        "middle_name": "A",
        "credential": "B.D.S., D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverford, PA

Sources for this page

Verify at the official NPI Registry.