Gentle Dental Tabor Road LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GENTLE DENTAL TABOR ROAD LLC

Practice address

1335 W Tabor Rd
Philadelphia, PA 19141-3038

Phone

(215) 548-8080

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

Insurance Director

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356465173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 W TABOR RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 W TABOR RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191413038",
            "telephone_number": "215-548-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENTLE DENTAL TABOR ROAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.