NPIMap

Organization Active NPI

Media Dental Associates DMD LLC

  • General Practice Dentistry
  • Media, PA
National Provider Identifier
1699231118
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MEDIA DENTAL ASSOCIATES DMD LLC
Practice address
511 N Providence Rd
Media, PA 19063-2518
Phone
(610) 565-0525
Fax
(610) 565-4724
NPI assigned
Feb 20, 2019
Last updated
Feb 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Jiten P Gohel, DMD
Title
President/Owner
Phone
(610) 565-0525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

511 N Providence Rd
Media, PA 19063-2518

Mailing address

511 N Providence Rd
Media, PA 19063-2518
Phone (610) 565-0525

National Provider Directory

National Provider Directory
Tax ID family
Media Dental Associates DMD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

511 N Providence Rd
Media, PA 19063
Phone (610) 565-0525

Practitioners & affiliated clinicians

Practitioners 9

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": "1550620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1699231118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 N PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632518",
            "telephone_number": "610-565-0525",
            "fax_number": "610-565-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 N PROVIDENCE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632518",
            "telephone_number": "610-565-0525",
            "fax_number": "610-565-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIA DENTAL ASSOCIATES DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "GOHEL",
        "authorized_official_first_name": "JITEN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "610-565-0525",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.