Individual provider Active NPI

Mirabela M. Gherca, D.D.S.

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1346490539
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS037587 Issued in PA
Practice address
600 W Olney Ave
Philadelphia, PA 19120-2220
Phone
(215) 549-6868
Fax
(215) 549-6860
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS037587 PA Primary

Addresses

Primary practice location

600 W Olney Ave
Philadelphia, PA 19120-2220

Mailing address

401 Commerce Dr
Suite #108
Ft Washington, PA 19034-2714
Phone (267) 460-4254

Other identifiers 1

IdentifierTypeStateIssuer
102223732MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS037587PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Family Dentistry P.C. General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1346490539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE DR",
            "address_2": "SUITE #108",
            "city": "FT WASHINGTON",
            "state": "PA",
            "postal_code": "190342714",
            "telephone_number": "267-460-4254",
            "fax_number": "215-646-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W OLNEY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191202220",
            "telephone_number": "215-549-6868",
            "fax_number": "215-549-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERCA",
        "first_name": "MIRABELA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS037587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102223732",
            "state": "PA"
        }
    ],
    "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 Feb 27, 2013; 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.