NPIMap

Organization Active NPI

Drexel Hill Smiles PC

  • General Practice Dentistry
  • Drexel Hill, PA
National Provider Identifier
1336747450
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DREXEL HILL SMILES PC
Practice address
4605 State Rd
Drexel Hill, PA 19026-4423
Phone
(610) 200-9200
NPI assigned
Oct 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Ketav Shah
Title
Office Manager
Phone
(610) 200-9200

Specialties & licenses 1

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

Addresses

Primary practice location

4605 State Rd
Drexel Hill, PA 19026-4423

Mailing address

4605 State Rd
Drexel Hill, PA 19026-4423
Phone (610) 200-9200

National Provider Directory

National Provider Directory

Locations

4605 State Rd
Drexel Hill, PA 19026
Phone (610) 200-9200

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1336747450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264423",
            "telephone_number": "610-200-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190264423",
            "telephone_number": "610-200-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREXEL HILL SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KETAV",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "610-200-9200"
    },
    "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 Drexel Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.