NPIMap

Organization Active NPI

Excel Endodontics of Pennsylvania, LLC

  • Dental Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1790044535
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS037946 Issued in PA
Legal business name
EXCEL ENDODONTICS OF PENNSYLVANIA, LLC
Practice address
2546 S Broad St
Philadelphia, PA 19145-4638
Phone
(215) 755-1001
Fax
(215) 755-1406
NPI assigned
May 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Authorized official

Name
Dr. Melissa Vettraino, D.D.S.
Title
Endodontist/Owner
Phone
(215) 755-1001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DS037946 PA Primary

Addresses

Primary practice location

2546 S Broad St
Philadelphia, PA 19145-4638

Mailing address

2546 S Broad St
Philadelphia, PA 19145-4638
Phone (215) 755-1001

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1790044535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454638",
            "telephone_number": "215-755-1001",
            "fax_number": "215-755-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454638",
            "telephone_number": "215-755-1001",
            "fax_number": "215-755-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL ENDODONTICS OF PENNSYLVANIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "VETTRAINO",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "ENDODONTIST/OWNER",
        "authorized_official_telephone_number": "215-755-1001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS037946",
            "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 May 15, 2012; 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.