Mount Airy Family Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MOUNT AIRY FAMILY DENTAL LLC

Practice address

1600 Ivy Hill Rd
Philadelphia, PA 19150-1008

Phone

(952) 649-9817

NPI assigned

Feb 27, 2020

Organization subpart

No

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

Authorized official

Name

Madhvi Patel

Title

Partner

Phone

(952) 649-9817

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1508490509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 IVY HILL RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501008",
            "telephone_number": "215-248-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 IVY HILL RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501008",
            "telephone_number": "952-649-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT AIRY FAMILY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MADHVI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "952-649-9817"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103246221",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lea Anne Moukarzel, M.D.
• Achintya Moulick, MD
• Amy Moulton, MA, LPC
• Alaa Mouminah
• Peter Mounas, DO
• Mount Airy Pain Management Center Inc. (Mount airy pain practice)
• Mount Mecca Home Care LLC
• Maria M Mountis, DO
• Karam C Mounzer, MD
• Tala Mourabet, DO

• 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 14, 2023; 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.