Active NPI
Smile Center on Roosevelt LLC
- General Practice Dentistry
- Philadelphia, PA
National Provider Identifier
1306756085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- SMILE CENTER ON ROOSEVELT LLC
- Practice address
- 6404 Roosevelt Blvd
Philadelphia, PA 19149-2943 - Phone
- (215) 558-4205
- NPI assigned
- Sep 8, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Belder, DDS
- Title
- Owner
- Phone
- (215) 558-4205
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
6404 Roosevelt Blvd
Philadelphia, PA 19149-2943
Mailing address
528 Street Rd
Southampton, PA 18966-3747
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788825600000",
"number": "1306756085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 STREET RD",
"city": "SOUTHAMPTON",
"state": "PA",
"postal_code": "189663747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6404 ROOSEVELT BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191492943",
"telephone_number": "215-558-4205"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMILE CENTER ON ROOSEVELT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A",
"authorized_official_last_name": "BELDER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "215-558-4205",
"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": []
}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 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.