Ismile Dental Group, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ISMILE DENTAL GROUP, PC

Practice address

6573 Roosevelt Blvd
Philadelphia, PA 19149

Phone

(267) 668-8001

Fax

(267) 668-8002

NPI assigned

Jul 13, 2015

Last updated

Mar 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Grace Harriman

Title

Director of Business Operations

Phone

(267) 668-8001

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1346624038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6573 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "267-668-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6573 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19149",
            "telephone_number": "267-668-8001",
            "fax_number": "267-668-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMILE DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "HARRIMAN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "267-668-8001",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayada Ismail, MD
• Omar Ibnee Ismail
• Sardora Ismailova, DMD
• Ismart Home Care
• Fraz A Ismat, M.D.
• Ismile Dental Team PC
• Nailah Isoke
• Nefertiti Isoke, RN, LCSW, CRNP
• Njemile Isoke, RN
• Marcel Isper

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2017; 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.