Overbrook Farms Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS029137L Issued in PA

Legal business name

OVERBROOK FARMS DENTAL GROUP

Practice address

2121 N 63Rd St
Philadelphia, PA 19151-2612

Phone

(215) 878-0058

Fax

(215) 878-3834

NPI assigned

Mar 17, 2009

Last updated

Mar 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Rostami, DMD

Title

Dentist

Phone

(215) 878-0058

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Rama L Yerneni, D.M.D

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1205894789
  NPD (past)

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1568603744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512612",
            "telephone_number": "215-878-0058",
            "fax_number": "215-878-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N 63RD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191512612",
            "telephone_number": "215-878-0058",
            "fax_number": "215-878-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERBROOK FARMS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-17",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "ROSTAMI",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-878-0058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029137L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Outside the Box Strategies, LLC
• Tamara Ouzounian, MD
• Charyl Ovalle, M.D.
• Massiel N Ovalles Perdomo
• Ryan Overberger, DO
• Overbrook Friedlander Programs
• Overbrook Friedlander Programs
• Overbrook Plaza Pharmacy
• Overbrook School for the Blind
• Overbrook School for the Blind

• 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 Mar 17, 2009; 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.