5TH Street Dental Center Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS018692-L Issued in PA

Legal business name

5TH STREET DENTAL CENTER INC

Practice address

4646 North 5TH St
Philadelphia, PA 19140

Phone

(215) 324-1950

Fax

(215) 324-1950

NPI assigned

Feb 15, 2007

Last updated

Apr 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon E Wilson

Title

Owner

Phone

(215) 324-1950

Specialties & licenses 1

Addresses

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.

• Candido Negron, DMD

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1215171954
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1801939012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 NORTH 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-324-1950",
            "fax_number": "215-324-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 NORTH 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-324-1950",
            "fax_number": "215-324-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH STREET DENTAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-324-1950"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS018692-L",
            "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 Apr 8, 2008; 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.