Active NPI
Jahi B Mtaalamu, DDS
- Dentist
- Philadelphia, PA
National Provider Identifier
1356457410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS023071L
- Practice address
- 555 S 43Rd St
Health Center #3
Philadelphia, PA 19104-4408 - Phone
- (215) 685-7522
- Fax
- (215) 685-7551
- NPI assigned
- Aug 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS023071L | PA | Primary |
Addresses
Primary practice location
555 S 43Rd St
Health Center #3
Philadelphia, PA 19104-4408
Mailing address
500 S Broad St
Dental Suite
Philadelphia, PA 19146-1613
Phone (215) 685-6768
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT173089 | Other | PA | 1 |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS023071L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356457410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 S BROAD ST",
"address_2": "DENTAL SUITE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191461613",
"telephone_number": "215-685-6768",
"fax_number": "215-685-6891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 S 43RD ST",
"address_2": "HEALTH CENTER #3",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044408",
"telephone_number": "215-685-7522",
"fax_number": "215-685-7551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MTAALAMU",
"first_name": "JAHI",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS023071L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1",
"identifier": "MT173089",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
- Mt Airy Family Practice
- Mt Airy Pediatrics, LLP
- Mt Airy/ Germantown Medical and Rehab Associates
- Mt. Airy Anesthesiology Associates, LLC
- Mt. Airy Pediatrics, P.C.
- Jeanette Mtanos, LMFT
- MTC Wellness, LLC
- MTP RX LLC (Medical Tower Pharmacy)
- MTP RX LLC (Medical Tower Pharmacy)
- Henrietta D Mtshali, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.