Individual provider Active NPI

Adam Semanoff, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Feasterville Trevose, PA
National Provider Identifier
1639419369
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS042037 Issued in PA
Practice address
1300 Bridgetown Pike
Feasterville Trevose, PA 19053-4326
Phone
(215) 322-7810
NPI assigned
Feb 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN23182 FL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS042037 PA Primary

Addresses

Primary practice location

1300 Bridgetown Pike
Feasterville Trevose, PA 19053-4326

Mailing address

1300 Bridgetown Pike
Feasterville Trevose, PA 19053-4326
Phone (215) 322-7810

Other practice location 1

638 Newtown Yardley Rd Ste 2A
Newtown, PA 18940-1739
Phone (215) 322-7810

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
I20190917001170 PA Practitioner - Oral Surgery 2062750755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Implant and Oral Surgery PCGroup PAC ID 3375635642, 5 clinicians

Practice addresses (Care Compare)

1300 Bridgetown Pike
Feasterville, PA 19053-4326
Phone (215) 322-7810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS042037PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Implant & Oral Surgery PC CurrentSince Jul 23, 2019 Accepting new patients

Locations

1494 Old York Rd
Fl 2
Abington, PA 19001
Phone (215) 322-7810

1300 Bridgetown Pike
Fstrvl Trvose, PA 19053
Phone (215) 322-7810

638 Newtown Yardley Rd
Ste 2A
Newtown, PA 18940
Phone (215) 322-7810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1639419369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BRIDGETOWN PIKE",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190534326",
            "telephone_number": "215-322-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BRIDGETOWN PIKE",
            "city": "FEASTERVILLE TREVOSE",
            "state": "PA",
            "postal_code": "190534326",
            "telephone_number": "215-322-7810"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "638 Newtown Yardley Rd Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189401739",
            "country_code": "US",
            "telephone_number": "215-322-7810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEMANOFF",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-16",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN23182",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS042037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Feasterville Trevose, PA

Sources for this page

Verify at the official NPI Registry.