NPIMap

Organization Active NPI

Advanced Family Dentistry, P.C.

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1619261682
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS-029417-L Issued in PA
Legal business name
ADVANCED FAMILY DENTISTRY, P.C.
Practice address
6100-02 5TH Street
Storefront
Philadelphia, PA 19120
Phone
(215) 224-4343
Fax
(215) 646-6369
NPI assigned
Jun 7, 2011
Last updated
Jun 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Authorized official

Name
Phi Le
Title
Credentialing Specialist
Phone
(267) 460-4254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS-029417-L PA Primary

Addresses

Primary practice location

6100-02 5TH Street
Storefront
Philadelphia, PA 19120

Mailing address

401 Commerce Dr
Suite 108
Fort Washington, PA 19034-2714
Phone (267) 460-4254

National Provider Directory

National Provider Directory
Tax ID family
Advanced Family Dentistry PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307404800000",
    "number": "1619261682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 COMMERCE DR",
            "address_2": "SUITE 108",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342714",
            "telephone_number": "267-460-4254",
            "fax_number": "215-646-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100-02 5TH STREET",
            "address_2": "STOREFRONT",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19120",
            "telephone_number": "215-224-4343",
            "fax_number": "215-646-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY DENTISTRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "PHI",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "267-460-4254"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS-029417-L",
            "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 Jun 7, 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.