NPIMap

Organization Active NPI

Temple University Kornberg School of Dentistry Community Dental Clinic

  • Dental Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1649566738
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS018795L Issued in PA
Legal business name
TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRY COMMUNITY DENTAL CLINIC
Practice address
3223 N. Broad St.
Philadelphia, PA 19140-5007
Phone
(215) 707-7756
Fax
(215) 707-5885
NPI assigned
Jun 27, 2011
Last updated
Jun 27, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Ms. Deborah Ricks
Title
Financial Manager
Phone
(215) 707-7756

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS018795L PA Primary

Addresses

Primary practice location

3223 N. Broad St.
Philadelphia, PA 19140-5007

Mailing address

3223 N Broad St
Philadelphia, PA 19140-5007
Phone (215) 707-7756

National Provider Directory

National Provider Directory
Tax ID family
Temple Critical Care As28 organizations share this tax ID, including this one
Part of
Temple Critical Care As

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1649566738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-7756",
            "fax_number": "215-707-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N. BROAD ST.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-7756",
            "fax_number": "215-707-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRY COMMUNITY DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEMPLE UNIVERSITY KORNBERG SCHOOL OF DENTISTRY",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "215-707-7756",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS018795L",
            "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 27, 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.