Fairview Dental Arts PC

Primary specialty

DentistTaxonomy code 122300000X

License

DS035996 Issued in PA

Legal business name

FAIRVIEW DENTAL ARTS PC

Practice address

1009 Valley Forge Rd
Eagleville, PA 19403-1022

Phone

(610) 630-2373

NPI assigned

Aug 20, 2015

Last updated

Aug 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Peter Thomas Andolino, DMD

Title

Dentist/President

Phone

(610) 630-2373

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1225404577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 VALLEY FORGE RD",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031022",
            "telephone_number": "610-630-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 VALLEY FORGE RD",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031022",
            "telephone_number": "610-630-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW DENTAL ARTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "ANDOLINO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "610-630-2373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS035996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Eagleville, PA
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• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.