NPIMap

Organization Active NPI

Jeffrey M Weiner DDS PC

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1558309161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-019951L Issued in PA
Legal business name
JEFFREY M WEINER DDS PC
Practice address
3254 Red Lion Rd
Philadelphia, PA 19114-1109
Phone
(215) 632-1612
Fax
(215) 632-3221
NPI assigned
Jun 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeffrey Marc Weiner, D.D.S.NPI 1003037292
Title
President
Phone
(215) 632-1612

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
General Practice Dentistry 1223G0001X DS-019951L PA Primary

Addresses

Primary practice location

3254 Red Lion Rd
Philadelphia, PA 19114-1109

Mailing address

3254 Red Lion Rd
Philadelphia, PA 19114-1109
Phone (215) 632-1612

Other identifiers 1

IdentifierTypeStateIssuer
421589OtherPAUNITED CONCORDIA ID

National Provider Directory

National Provider Directory

Locations

3254 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 632-1612

Practitioners & affiliated clinicians

Practitioners 6

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558309161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3254 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141109",
            "telephone_number": "215-632-1612",
            "fax_number": "215-632-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3254 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141109",
            "telephone_number": "215-632-1612",
            "fax_number": "215-632-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M WEINER DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-632-1612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-019951L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID",
            "identifier": "421589",
            "state": "PA"
        }
    ],
    "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 Aug 22, 2020; 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.