Premier Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS036040 Issued in PA

Legal business name

PREMIER DENTAL

Practice address

390 Vineyard Way
Suite 505
West Grove, PA 19390-8835

Phone

(610) 869-0655

Fax

(610) 869-6099

NPI assigned

Aug 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Diane C Hernandez, D.M.D.NPI 1194939595

Title

Owner

Phone

(610) 869-6055

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diane C Hernandez, DMD

  • General Practice Dentistry
  • West Grove, PA
  • NPI 1194939595
  NPD (past) Authorized official
• Milan Nico Khazana, DMD

  • General Practice Dentistry
  • West Grove, PA
  • NPI 1912836974
  NPD (past)

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1821280272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 VINEYARD WAY",
            "address_2": "SUITE 505",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908835",
            "telephone_number": "610-869-0655",
            "fax_number": "610-869-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 VINEYARD WAY",
            "address_2": "SUITE 505",
            "city": "WEST GROVE",
            "state": "PA",
            "postal_code": "193908835",
            "telephone_number": "610-869-0655",
            "fax_number": "610-869-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-869-6055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS036040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andi Peters
• Physiotherapy Associates Inc (Physiotherapy Associates)
• Nicole Lynn Pickrell
• Debra Pisarcik, D.M.D.
• Richard Ivan Plotzker, MD
• Premier Orthopaedic and Sports Medicine Associates LTD
• Premier Orthopaedic and Sports Medicine Associates, LTD
• Ramesht LLC
• Razaullah a. Khwaja, M.D.
• Ysan Miller Reischke, P.T.

• General Practice Dentistry in West Grove, PA
• Providers in West Grove, 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 Aug 9, 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.