Individual provider Active NPI

Mark Meraner, DDS

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1598057994
Registry record updated May 4, 2011
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS021469L Issued in PA
Practice address
3223 N Broad St
Temple University Kornberg School of Dentistry
Philadelphia, PA 19140-5007
Phone
(215) 707-3996
NPI assigned
May 4, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS021469L PA Primary

Addresses

Primary practice location

3223 N Broad St
Temple University Kornberg School of Dentistry
Philadelphia, PA 19140-5007

Mailing address

3223 N Broad St
Temple University Kornberg School of Dentistry
Philadelphia, PA 19140-5007
Phone (215) 707-3996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609001699 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507187069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1598057994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "address_2": "TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "address_2": "TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERANER",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS021469L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.