NPIMap

Organization Active NPI

Broomall Pediatric Dentistry & Orthodontics,P.C.

  • Pediatric Dentistry
  • Havertown, PA
National Provider Identifier
1336202787
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
BROOMALL PEDIATRIC DENTISTRY & ORTHODONTICS,P.C.
Practice address
1220 W Chester Pike
Havertown, PA 19083-3339
Phone
(484) 454-3230
Fax
(484) 455-7186
NPI assigned
Dec 18, 2006
Last updated
Apr 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Dr. Jay Goldsleger, D.D.S.
Title
Dentist,Owner
Phone
(484) 454-3230

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X PA
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X PA Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X PA

Addresses

Primary practice location

1220 W Chester Pike
Havertown, PA 19083-3339

Mailing address

1220 W Chester Pike
Havertown, PA 19083-3339
Phone (484) 454-3230

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1336202787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833339",
            "telephone_number": "484-454-3230",
            "fax_number": "484-455-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W CHESTER PIKE",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833339",
            "telephone_number": "484-454-3230",
            "fax_number": "484-455-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOMALL PEDIATRIC DENTISTRY & ORTHODONTICS,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "GOLDSLEGER",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "DENTIST,OWNER",
        "authorized_official_telephone_number": "484-454-3230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.