Active NPI
Craig Barry Soffin, DMD
- Endodontics
- King of Prussia, PA
National Provider Identifier
1245344324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS019971L
- Practice address
- 491 Allendale Road
Suite 206
King of Prussia, PA 19406-1431 - Phone
- (610) 337-0110
- Fax
- (610) 337-2102
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS019971L | PA | Primary |
Addresses
Primary practice location
491 Allendale Road
Suite 206
King of Prussia, PA 19406-1431
Mailing address
491 Allendale Road
Suite 206
King of Prussia, PA 19406-1431
Phone (610) 337-0110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 15, 2016 through Feb 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS019971L | PA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| King of Prussia Dental Associates | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- King of Prussia, PA
- NPI 1619079704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245344324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "491 ALLENDALE ROAD",
"address_2": "SUITE 206",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194061431",
"telephone_number": "610-337-0110",
"fax_number": "610-337-2102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "491 ALLENDALE ROAD",
"address_2": "SUITE 206",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194061431",
"telephone_number": "610-337-0110",
"fax_number": "610-337-2102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOFFIN",
"first_name": "CRAIG",
"middle_name": "BARRY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS019971L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in King of Prussia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.