Idental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS037477 Issued in PA

Legal business name

IDENTAL, PC

Practice address

2601 E Allegheny Ave
Philadelphia, PA 19134-5103

Phone

(267) 262-2834

NPI assigned

Jun 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Zaliya Akbasheva

Title

Owner

Phone

(267) 262-2834

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1245611672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191345103",
            "telephone_number": "267-262-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191345103",
            "telephone_number": "267-262-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "AKBASHEVA",
        "authorized_official_first_name": "ZALIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-262-2834",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Philadelphia, PA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.