Active NPI
Glenn B Dempsey, M.D.
- Dermatology Physician
- Philadelphia, PA
National Provider Identifier
1568555274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD058798L
- Practice address
- 9892 Bustleton Avenue
Ste 204 Moss Plaza
Philadelphia, PA 19115 - Phone
- (215) 676-2464
- Fax
- (215) 676-5536
- NPI assigned
- Oct 2, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD058798L | PA | Primary |
Addresses
Primary practice location
9892 Bustleton Avenue
Ste 204 Moss Plaza
Philadelphia, PA 19115
Mailing address
822 Montgomery Avenue
Ste 100
Narberth, PA 19072
Phone (610) 664-4433
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD058798L | PA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568555274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 MONTGOMERY AVENUE",
"address_2": "STE 100",
"city": "NARBERTH",
"state": "PA",
"postal_code": "19072",
"telephone_number": "610-664-4433",
"fax_number": "640-664-5290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9892 BUSTLETON AVENUE",
"address_2": "STE 204 MOSS PLAZA",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19115",
"telephone_number": "215-676-2464",
"fax_number": "215-676-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMPSEY",
"first_name": "GLENN",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "PA",
"license": "MD058798L",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.