NPIMap

Organization Active NPI

White Willow Dental Arts

  • Dental Clinic/Center
  • Fort Washington, PA
National Provider Identifier
1760841084
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS039121 Issued in PA
Legal business name
WHITE WILLOW DENTAL ARTS
Practice address
1244 Fort Washington Ave
Suite a
Fort Washington, PA 19034-1743
Phone
(215) 643-0363
NPI assigned
Feb 15, 2016
Last updated
Feb 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Authorized official

Name
Dr. Paola Bukovcan, DMDNPI 1174752018
Title
Owner
Phone
(215) 410-2049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS039121 PA Primary

Addresses

Primary practice location

1244 Fort Washington Ave
Suite a
Fort Washington, PA 19034-1743

Mailing address

1413 Beech Ave
Elkins Park, PA 19027-3152

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1760841084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 BEECH AVE",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190273152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1244 FORT WASHINGTON AVE",
            "address_2": "SUITE A",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190341743",
            "telephone_number": "215-643-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE WILLOW DENTAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "BUKOVCAN",
        "authorized_official_first_name": "PAOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-410-2049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS039121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.