NPIMap

Organization Active NPI

Edgewood Dental LLC

  • Dentist
  • Yardey, PA
National Provider Identifier
1679682298
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS028078L Issued in PA
Legal business name
EDGEWOOD DENTAL LLC
Practice address
301 Oxford Valley Rd
Suite 1105a
Yardey, PA 19067
Phone
(215) 493-7000
Fax
(215) 493-7002
NPI assigned
Aug 29, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Antoinette Slavin
Title
Office Manager
Phone
(215) 493-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS026744L PA
Dentist 122300000X DS028968L PA
Dentist 122300000X DS028078L PA Primary

Addresses

Primary practice location

301 Oxford Valley Rd
Suite 1105a
Yardey, PA 19067

Mailing address

301 Oxford Valley Rd
Suite 1105a
Yardey, PA 19067
Phone (215) 493-7000

National Provider Directory

National Provider Directory

Locations

301 Oxford Valley Rd
Ste 1105A
Yardley, PA 19067
Phone (215) 493-7000

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679682298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "SUITE 1105A",
            "city": "YARDEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-7000",
            "fax_number": "215-493-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "SUITE 1105A",
            "city": "YARDEY",
            "state": "PA",
            "postal_code": "19067",
            "telephone_number": "215-493-7000",
            "fax_number": "215-493-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWOOD DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLAVIN",
        "authorized_official_first_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-493-7000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS026744L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS028968L",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS028078L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.