Dpmkentnerprpa LLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

SC004823L Issued in PA

Legal business name

DPMKENTNERPRPA LLC

Practice address

1923 Welsh Rd
Philadelphia, PA 19115-4659

Phone

(215) 677-3222

Fax

(215) 677-3241

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Bryan Kentner, DPM

Title

Owner

Phone

(215) 696-3674

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1801925078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11773 DIMARCO DR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191543716",
            "telephone_number": "215-696-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 WELSH RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154659",
            "telephone_number": "215-677-3222",
            "fax_number": "215-677-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPMKENTNERPRPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "KENTNER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-696-3674",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC004823L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Primary Podiatric Medicine Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.