Team Dental N Liberties, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

24547 Issued in NJ

Legal business name

TEAM DENTAL N LIBERTIES, LLC

Practice address

992 N 2ND St
Philadelphia, PA 19123-2313

Phone

(215) 589-5100

Fax

(215) 515-3685

NPI assigned

Dec 6, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Murtuza Jaffari, DMD

Title

Owner/ Dentist

Phone

(215) 589-5100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1770027989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 N 2ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232313",
            "telephone_number": "215-589-5100",
            "fax_number": "215-515-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 N 2ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232313",
            "telephone_number": "215-589-5100",
            "fax_number": "215-515-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM DENTAL N LIBERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "JAFFARI",
        "authorized_official_first_name": "MURTUZA",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "215-589-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "24547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.