NPIMap

Organization Active NPI

Temple University

  • Periodontics
  • Philadelphia, PA
National Provider Identifier
1720526130
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
0401414955 Issued in VA
Legal business name
TEMPLE UNIVERSITY
Practice address
3223 N Broad St
Dept of Periodontology
Philadelphia, PA 19140-5007
Phone
(215) 707-5774
NPI assigned
Feb 6, 2017
Last updated
Feb 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Authorized official

Name
Dr. Keisuke Wada, DMD
Title
Director Chair of Periodontology
Phone
(215) 707-7667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 0401414955 VA Primary

Addresses

Primary practice location

3223 N Broad St
Dept of Periodontology
Philadelphia, PA 19140-5007

Mailing address

3223 N Broad St
Philadelphia, PA 19140-5007
Phone (215) 707-5774

National Provider Directory

National Provider Directory
Tax ID family
Temple Rheumatology Ass28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1720526130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 N BROAD ST",
            "address_2": "DEPT OF PERIODONTOLOGY",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405007",
            "telephone_number": "215-707-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "WADA",
        "authorized_official_first_name": "KEISUKE",
        "authorized_official_title_or_position": "DIRECTOR CHAIR OF PERIODONTOLOGY",
        "authorized_official_telephone_number": "215-707-7667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401414955",
            "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 Feb 6, 2017; 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.