NPIMap

Organization Active NPI

Main Line Dental Group PC

  • Prosthodontics
  • Wayne, PA
National Provider Identifier
1679618433
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DS022342L Issued in PA
Legal business name
MAIN LINE DENTAL GROUP PC
Practice address
744 West Lancaster Ave
Devon Square II Suite 115
Wayne, PA 19087-2523
Phone
(610) 971-0717
Fax
(610) 971-9781
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Authorized official

Name
Dr. Ronald Craig Williams, DMDNPI 1245586882
Title
Owner President
Phone
(610) 971-0717

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
ProsthodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0700X DS022342L PA Primary

Addresses

Primary practice location

744 West Lancaster Ave
Devon Square II Suite 115
Wayne, PA 19087-2523

Mailing address

744 W Lancaster Ave
Devon Square II Suite 115
Wayne, PA 19087-2523
Phone (610) 971-0717

National Provider Directory

National Provider Directory

Locations

744 Lancaster Ave
Ste 115
Wayne, PA 19087
Phone (610) 971-0717

Practitioners & affiliated clinicians

Practitioners 5

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1679618433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W LANCASTER AVE",
            "address_2": "DEVON SQUARE II SUITE 115",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872523",
            "telephone_number": "610-971-0717",
            "fax_number": "610-971-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 WEST LANCASTER AVE",
            "address_2": "DEVON SQUARE II SUITE 115",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190872523",
            "telephone_number": "610-971-0717",
            "fax_number": "610-971-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "610-971-0717",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS022342L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.