Elkins Park Orthodontics PC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DS039086 Issued in PA

Legal business name

ELKINS PARK ORTHODONTICS PC

Doing business as

Elkins Park Orthodontist PC

Practice address

7900 Old York Rd
Suite 108a
Elkins Park, PA 19027-2318

Phone

(215) 808-6473

Fax

(215) 638-0907

NPI assigned

Aug 29, 2016

Organization subpart

No

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

Authorized official

Name

Jiawonia Right

Title

Office Manager

Phone

(215) 635-0808

Specialties & licenses 1

Addresses

Other names 1

• Elkins Park Orthodontist PC Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erin Ruane Bauerle, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Havertown, PA
  • NPI 1003158528
  NPD (past)
• Omid Mehdipour, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Elkins Park, PA
  • NPI 1376700336
  NPD (past)

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1316493471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "SUITE 108A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-808-6473",
            "fax_number": "215-638-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 OLD YORK RD",
            "address_2": "SUITE 108A",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190272318",
            "telephone_number": "215-808-6473",
            "fax_number": "215-638-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKINS PARK ORTHODONTICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "RIGHT",
        "authorized_official_first_name": "JIAWONIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-635-0808"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS039086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkins Park Orthodontist PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elkins Crest Health & Rehabilitation Center, LLC
• Elkins Park Chiropractic Center LLC
• Elkins Park Dental Innovations PC
• Elkins Park Dental, Inc.
• Elkins Park Oral Surgery, Inc (Elkins Park Dental Specialist)
• Elkins Park Orthodontist
• Elkins Park Pharmacy Inc.
• Elkins Park Physical Therapy LLC
• Julius Ellison, MD
• Empire Healthcare Systems (Healthbridge Chiropractic)

• Orthodontics and Dentofacial Orthopedics Dentistry in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.