Organization Active NPI

Lansdale Periodontal Associates, PC

  • Periodontics
  • Lansdale, PA
National Provider Identifier
1710355102
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DS036734 Issued in PA
Legal business name
LANSDALE PERIODONTAL ASSOCIATES, PC
Practice address
2100 N Broad St
Ste 204
Lansdale, PA 19446-1052
Phone
(215) 368-5110
Fax
(215) 368-2017
NPI assigned
Sep 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

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

Authorized official

Name
Dr. Howard Gross, D.D.S., M.SC.D.
Title
President
Phone
(215) 368-5110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X DS036734 PA Primary

Addresses

Primary practice location

2100 N Broad St
Ste 204
Lansdale, PA 19446-1052

Mailing address

2100 N Broad St
Ste 204
Lansdale, PA 19446-1052
Phone (215) 368-5110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1710355102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N BROAD ST",
            "address_2": "STE 204",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461052",
            "telephone_number": "215-368-5110",
            "fax_number": "215-368-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N BROAD ST",
            "address_2": "STE 204",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194461052",
            "telephone_number": "215-368-5110",
            "fax_number": "215-368-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANSDALE PERIODONTAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-368-5110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.SC.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS036734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.