Philadelphia Smile Ceter LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PHILADELPHIA SMILE CETER LLC

Practice address

11911 Bustleton Ave
Philadelphia, PA 19116-2541

Phone

(215) 673-9050

NPI assigned

May 29, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Kiril Sharkov

Title

Office Manager

Phone

(215) 391-5939

Specialties & licenses 1

Addresses

Other names 1

• Philadelphia Smile Center Other name

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1396585212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 OLD YORK RD",
            "city": "ABINGTON",
            "state": "PA",
            "postal_code": "190011907",
            "telephone_number": "215-558-4205",
            "fax_number": "215-494-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162541",
            "telephone_number": "215-673-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA SMILE CETER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "SHARKOV",
        "authorized_official_first_name": "KIRIL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-391-5939",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philadelphia Smile Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Philadelphia Ronald McDonald House Inc
• Philadelphia School of Psychoanalysis
• Philadelphia School of Psychoanalysis
• Philadelphia Senior Care LLC
• Philadelphia Sleep Center Inc.
• Philadelphia Spine and Wellness CNTR.
• Philadelphia Spine Associates
• Philadelphia Supportive Living Solutions
• Philadelphia Supportive Living Solutions LLC
• Philadelphia Surgi Center, Inc.

• 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 May 29, 2024; 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.