Academy of Modern Implants & Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ACADEMY OF MODERN IMPLANTS & DENTISTRY

Practice address

700 S Henderson Rd Ste 306
King of Prussia, PA 19406-4208

Phone

(484) 685-3933

NPI assigned

Mar 11, 2020

Last updated

Mar 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Corey Raymond, DMD

Title

Owner

Phone

(484) 685-3933

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1699300475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD STE 306",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064208",
            "telephone_number": "484-685-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S HENDERSON RD STE 306",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194064208",
            "telephone_number": "484-685-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY OF MODERN IMPLANTS & DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-685-3933",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.academyofmodernimplantdentistry.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "700 S Henderson Rd Ste 306",
            "city": "King Of Prussia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "194064208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Khabirah Acosta, OD
• Adam J. Weiss, D.M.D., P.C.
• Mary Adefemi
• Onikepe Adegbola, MD PHD

• Dental Clinic/Center in King of Prussia, PA
• Providers in King of Prussia, 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 Mar 11, 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.