NPIMap

Organization Active NPI

United Dental USA LLC

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1356714448
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS019126L Issued in PA
Legal business name
UNITED DENTAL USA LLC
Practice address
1501 E Wadsworth Ave
Philadelphia, PA 19150-1605
Phone
(267) 774-5629
Fax
(267) 774-5639
NPI assigned
Nov 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Authorized official

Name
Jared Ayes
Title
Operations Manager
Phone
(267) 774-5629

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS019126L PA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DS019126L PA

Addresses

Primary practice location

1501 E Wadsworth Ave
Philadelphia, PA 19150-1605

Mailing address

1501 E Wadsworth Ave
Philadelphia, PA 19150-1605
Phone (267) 774-5629

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447200000000",
    "number": "1356714448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E WADSWORTH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501605",
            "telephone_number": "267-774-5629",
            "fax_number": "267-774-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E WADSWORTH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501605",
            "telephone_number": "267-774-5629",
            "fax_number": "267-774-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL USA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A",
        "authorized_official_last_name": "AYES",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "267-774-5629"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS019126L",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS019126L",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Nov 11, 2015; 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.