NPIMap

Organization Active NPI

Prime Time Dental

  • Preferred Provider Organization
  • Norristown, PA
National Provider Identifier
1558656124
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
00389NO07133833 Issued in PA
Legal business name
PRIME TIME DENTAL
Practice address
1548 Dekalb St
Norristown, PA 19401-3425
Phone
(610) 277-7645
Fax
(610) 277-7644
NPI assigned
Jun 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Authorized official

Name
Bob Sulimanov
Title
Manager
Phone
(610) 277-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 00389NO07133833 PA Primary

Addresses

Primary practice location

1548 Dekalb St
Norristown, PA 19401-3425

Mailing address

1548 Dekalb St
Norristown, PA 19401-3425
Phone (610) 277-7645

National Provider Directory

National Provider Directory

Locations

1548 DeKalb St
Norristown, PA 19401
Phone (610) 277-7645

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1558656124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013425",
            "telephone_number": "610-277-7645",
            "fax_number": "610-277-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013425",
            "telephone_number": "610-277-7645",
            "fax_number": "610-277-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME TIME DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-12",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "SULIMANOV",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "610-277-7645"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "PA",
            "license": "00389NO07133833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norristown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.