NPIMap

Organization Active NPI

Dental Cloud

Doing business as brookline dental associates

  • Dentist
  • Havertown, PA
National Provider Identifier
1700331253
Registry record updated Aug 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS037769 Issued in PA
Legal business name
DENTAL CLOUD
Doing business as
brookline dental associates
Practice address
40 Brookline Blvd
Havertown, PA 19083-3802
Phone
(610) 314-8881
NPI assigned
Aug 24, 2016
Last updated
Aug 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2016

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

Authorized official

Name
Dr. Samera Mumtaz, DMD
Title
Owner
Phone
(610) 314-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DS037769 PA Primary

Addresses

Primary practice location

40 Brookline Blvd
Havertown, PA 19083-3802

Mailing address

40 Brookline Blvd
Havertown, PA 19083-3802
Phone (610) 314-8881

Other names 1

  • brookline dental associates Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1700331253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BROOKLINE BLVD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833802",
            "telephone_number": "610-314-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BROOKLINE BLVD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833802",
            "telephone_number": "610-314-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CLOUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "MUMTAZ",
        "authorized_official_first_name": "SAMERA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-314-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brookline dental associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.