Individual provider Active NPI

Frank Joseph Doroba III, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
National Provider Identifier
1639446834
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS038819 Issued in PA
Practice address
909 Walnut St
3Rd Floor Cob
Philadelphia, PA 19107-5211
Phone
(215) 955-6215
NPI assigned
Nov 16, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS038819 PA Primary

Addresses

Primary practice location

909 Walnut St
3Rd Floor Cob
Philadelphia, PA 19107-5211

Mailing address

834 Chestnut St Apt 1506
Philadelphia, PA 19107-5146
Phone (609) 847-7554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151005000207 NJ Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 7911130109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS038819PAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Porter, Martin, Salman, P.a. Oral and Maxillofacial Surgery CurrentSince Jan 26, 2022 Accepting new patients

Locations

195 N Haddon Ave
Haddonfield, NJ 08033
Phone (609) 429-9097

94 Brick Rd
Ste 100
Marlton, NJ 08053
Phone (856) 596-9099

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1639446834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 CHESTNUT ST APT 1506",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075146",
            "telephone_number": "609-847-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 WALNUT ST",
            "address_2": "3RD FLOOR COB",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075211",
            "telephone_number": "215-955-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROBA",
        "first_name": "FRANK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS038819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.