South Philadelphia Dental Group

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DS-030824-L Issued in PA

Legal business name

SOUTH PHILADELPHIA DENTAL GROUP

Practice address

1815 S Broad St
Philadelphia, PA 19148-2115

Phone

(215) 462-6229

Fax

(215) 467-9080

NPI assigned

Aug 10, 2007

Last updated

Aug 10, 2007By 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. Gregory Chess

Title

Partner

Phone

(215) 462-6229

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1255523650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482115",
            "telephone_number": "215-462-6229",
            "fax_number": "215-467-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482115",
            "telephone_number": "215-462-6229",
            "fax_number": "215-467-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PHILADELPHIA DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "CHESS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "215-462-6229",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS-030824-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Souneek at Your Service Home Care Agency
• Eirini Souroulidi, LSW
• Christine V Soutendijk, MD
• South Eastern Pennsylvania Medical Supplies
• South Philadelphia Dental Associates
• South Philadelphia Family Medicine
• South Philadelphia Open MRI, LLC (South Philadelphia Open MRI)
• South Philadelphia Orthodontic Associates
• South Philadelphia Pain Management
• South Philadelphia Pediatrics

• Dental Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; 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.