Organization Active NPI

Quaker City Dental

  • Dental Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1396269528
Registry record updated Jul 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
QUAKER CITY DENTAL
Practice address
1015 Chestnut St Ste 1117
Philadelphia, PA 19107-4334
Phone
(215) 923-3999
NPI assigned
Jul 30, 2017
Last updated
Jul 30, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2017

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

Authorized official

Name
Derek Conover, DMDNPI 1245547603
Title
Owner/Member
Phone
(215) 567-0521

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1015 Chestnut St Ste 1117
Philadelphia, PA 19107-4334

Mailing address

1015 Chestnut St Ste 1117
Philadelphia, PA 19107-4334

National Provider Directory

National Provider Directory

Locations

1015 Chestnut St
Ste 1117
Philadelphia, PA 19107
Phone (215) 923-3999

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1501372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501372800000",
    "number": "1396269528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST STE 1117",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT ST STE 1117",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074334",
            "telephone_number": "215-923-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAKER CITY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-30",
        "last_updated": "2017-07-30",
        "status": "A",
        "authorized_official_last_name": "CONOVER",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "215-567-0521",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 30, 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.