Organization Active NPI

NN Dental Services Co

Doing business as NN Dental

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1548119662
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NN DENTAL SERVICES CO
Doing business as
NN Dental
Practice address
11710 Bustleton Ave
Philadelphia, PA 19116-2516
Phone
(215) 969-2089
NPI assigned
Jan 22, 2026
Last updated
Jan 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Ms. Nino Goginashvili
Title
Owner
Phone
(215) 969-2089

Specialties & licenses 1

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

Addresses

Primary practice location

11710 Bustleton Ave
Philadelphia, PA 19116-2516

Mailing address

11710 Bustleton Ave
Philadelphia, PA 19116-2516
Phone (215) 969-2089

Other names 1

  • NN Dental Doing business as

National Provider Directory

National Provider Directory

Locations

11710 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 969-2089

NPI Registry JSON

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

{
    "created_epoch": "1769040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1548119662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162516",
            "telephone_number": "215-969-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 BUSTLETON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162516",
            "telephone_number": "215-969-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NN DENTAL SERVICES CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-22",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "GOGINASHVILI",
        "authorized_official_first_name": "NINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-969-2089",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NN Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 22, 2026; 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.