Dental Wizard G PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL WIZARD G PC

Practice address

2338 N Front St
Philadelphia, PA 19133-3716

Phone

(267) 886-9474

NPI assigned

Jan 12, 2018

Organization subpart

No

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

Authorized official

Name

Oleg Genis, DMD

Title

Owner

Phone

(267) 886-9474

Specialties & licenses 1

Addresses

Other names 2

• Diamante Dental Doing business as
• Paradise Dental Doing business as

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1417465402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 N FRONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191333716",
            "telephone_number": "267-886-9474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 E Allegheny Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191342207",
            "country_code": "US",
            "telephone_number": "215-995-2725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DENTAL WIZARD G PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "GENIS",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-886-9474",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamante Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paradise Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Specialist of Philadelphia PC
• Dental Wizard, PC
• Dentalux, LLC
• Dentam Inc
• Dentex Dental Group
• Dentex Dental Group,LTD

• 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 Jun 16, 2018; 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.