NPIMap

Organization Active NPI

Edp of Pennsylvania PC

Doing business as Gilbert Dental Care

  • Dental Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1225590318
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EDP OF PENNSYLVANIA PC
Doing business as
Gilbert Dental Care
Practice address
1500 Market St
Philadelphia, PA 19102-2100
Phone
(312) 800-1240
NPI assigned
Apr 5, 2019
Organization subpart
Yes
Parent organization
EDP OF PENNSYLVANIA PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Roseanne Brunenkant
Title
Director of Integrations
Phone
(312) 937-3619

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1500 Market St
Philadelphia, PA 19102-2100

Mailing address

141 W Jackson Blvd Ste 210
Chicago, IL 60604-3048
Phone (312) 937-3619

Other names 1

  • Gilbert Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Edp of Pennsylvania PC6 organizations share this tax ID, including this one
Part of
Edp of Pennsylvania PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

141 W Jackson Blvd
Ste 210
Chicago, IL 60604
Phone (312) 736-8963

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1225590318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W JACKSON BLVD STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606043048",
            "telephone_number": "312-937-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022100",
            "telephone_number": "312-800-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDP OF PENNSYLVANIA PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDP OF PENNSYLVANIA PC",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "BRUNENKANT",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_title_or_position": "DIRECTOR OF INTEGRATIONS",
        "authorized_official_telephone_number": "312-937-3619"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gilbert Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gilbert Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 16, 2019; 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.