Active NPI
Specialty Management
- Orthodontics and Dentofacial Orthopedics Dentistry
- Philadelphia, PA
National Provider Identifier
1720259583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Legal business name
- SPECIALTY MANAGEMENT
- Practice address
- 626 Snyder Ave
Suite 200
Philadelphia, PA 19148-2419 - Phone
- (267) 940-0300
- NPI assigned
- Mar 19, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Sophia Avanzato
- Title
- President/Ceo
- Phone
- (484) 432-2737
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | |||
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | Primary |
Addresses
Primary practice location
626 Snyder Ave
Suite 200
Philadelphia, PA 19148-2419
Mailing address
626 Snyder Ave
Suite 200
Philadelphia, PA 19148-2419
Phone (267) 940-0300
National Provider Directory
National Provider DirectoryLocations
626 Snyder Ave
Ste 200
Philadelphia, PA 19148
Phone (267) 940-0300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205884800000",
"number": "1720259583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "626 SNYDER AVE",
"address_2": "SUITE 200",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191482419",
"telephone_number": "267-940-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 SNYDER AVE",
"address_2": "SUITE 200",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191482419",
"telephone_number": "267-940-0300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPECIALTY MANAGEMENT",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-19",
"last_updated": "2008-03-19",
"status": "A",
"authorized_official_last_name": "AVANZATO",
"authorized_official_first_name": "SOPHIA",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "484-432-2737",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.