NPIMap

Organization Active NPI

Miracle Dental Center

  • General Practice Dentistry
  • Southampton, PA
National Provider Identifier
1306402524
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MIRACLE DENTAL CENTER
Doing business as
Miracle Dental Center
Practice address
963 Street Rd # a
Southampton, PA 18966-4728
Phone
(267) 990-8668
NPI assigned
May 13, 2019
Last updated
May 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Irina Frolov, DDSNPI 1760897581
Title
Owner/Dentist
Phone
(267) 882-7672

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

963 Street Rd # a
Southampton, PA 18966-4728

Mailing address

963 Street Rd # a
Southampton, PA 18966-4728
Phone (267) 990-8668

Other names 1

  • Miracle Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Miracle Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

963 Street Rd
#A
Southampton, PA 18966
Phone (267) 990-8668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1306402524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 STREET RD # A",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664728",
            "telephone_number": "267-990-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "963 STREET RD # A",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664728",
            "telephone_number": "267-990-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "FROLOV",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "267-882-7672",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.