Crentist PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CRENTIST PC

Doing business as

Ridley Dental Center

Practice address

1100 Macdade Blvd
Woodlyn, PA 19094-1322

Phone

(610) 833-1919

NPI assigned

Dec 7, 2019

Organization subpart

No

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

Authorized official

Name

Jordan Klinkner

Title

President

Phone

(917) 523-9800

Specialties & licenses 1

Addresses

Other names 1

• Ridley Dental Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sapna Srivastava

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1396148490
  NPD

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

{
    "created_epoch": "1575676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575676800000",
    "number": "1649817719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MACDADE BLVD",
            "city": "WOODLYN",
            "state": "PA",
            "postal_code": "190941322",
            "telephone_number": "610-833-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MACDADE BLVD",
            "city": "WOODLYN",
            "state": "PA",
            "postal_code": "190941322",
            "telephone_number": "610-833-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRENTIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-07",
        "last_updated": "2019-12-07",
        "certification_date": "2019-12-07",
        "status": "A",
        "authorized_official_last_name": "KLINKNER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-523-9800"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridley Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordana Blumenfield, MA, NCC, LPC, CSAT
• Campton Dialysis LLC (Woodlyn Dialysis)
• Crystal E Casmirri, DPT
• Chenee Home Health Care LLC
• Ryan Cullinan
• Gina Decarolis, PHARMD
• Mary Deitch, JD, PSY.D
• Dynamic Injury Solutions, LLC
• Dynamic Therapy Services LLC (Pivot Physical Therapy of Mid Atlantic LLC)

• Dental Clinic/Center in Woodlyn, PA
• Providers in Woodlyn, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2019; 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.