Philadelphia Dental Cosmetics

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PHILADELPHIA DENTAL COSMETICS

Practice address

1601 Walnut St
Suite 822
Philadelphia, PA 19102

Phone

(215) 557-7979

Fax

(215) 557-7930

NPI assigned

Mar 25, 2020

Last updated

Mar 25, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

PHILADELPHIA DENTAL COSMETICSAs reported in NPPES

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

Authorized official

Name

Jay J Liu, DMD, FICOINPI 1699828806

Title

Owner (Self)

Phone

(267) 250-8082

Specialties & licenses 1

Addresses

Part of

Philadelphia Dental Cosmetics

Locations

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.

• Jay Liu, DMD

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1699828806
  NPD (past) Authorized official

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1770110272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "SUITE 822",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-557-7979",
            "fax_number": "215-557-7930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST",
            "address_2": "SUITE 822",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-557-7979",
            "fax_number": "215-557-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA DENTAL COSMETICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHILADELPHIA DENTAL COSMETICS",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER (SELF)",
        "authorized_official_telephone_number": "267-250-8082",
        "authorized_official_credential": "DMD, FICOI"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philadelphia Dental
• Philadelphia Dental
• Philadelphia Dental
• Philadelphia Dental
• Philadelphia Dental Arts PC
• Philadelphia Dental Smiles PC
• Philadelphia Department of Public Health Center Pharmacy #1 (Health Center #1 Pharmacy)
• Philadelphia Department of Public Health Center Pharmacy #10 (Pharmacy Health Center #10)
• Philadelphia Department of Public Health Center Pharmacy #2 (Pharmacy Health Center #2)
• Philadelphia Department of Public Health Center Pharmacy #3 (Pharmacy Health Center #3)

• 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 Mar 25, 2020; 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.