Organization Active NPI

Elegance in Dentistry

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1679094148
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELEGANCE IN DENTISTRY
Practice address
1 Winding Dr
Philadelphia, PA 19131-2907
Phone
(215) 883-0611
Fax
(267) 713-7371
NPI assigned
Jul 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
Dr. Kellyn Hodges, DMDNPI 1194874156
Title
Doctor
Phone
(610) 617-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1 Winding Dr
Philadelphia, PA 19131-2907

Mailing address

1 Belmont Ave Ste 414
Bala Cynwyd, PA 19004-1607
Phone (610) 617-0700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1679094148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BELMONT AVE STE 414",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041607",
            "telephone_number": "610-617-0700",
            "fax_number": "610-617-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WINDING DR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312907",
            "telephone_number": "215-883-0611",
            "fax_number": "267-713-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEGANCE IN DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-05",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "KELLYN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "610-617-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 4, 2024; 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.