NPIMap

Organization Active NPI

Pennsylvania Dental Associates LTD

  • Dentist
  • Philadelphia, PA
National Provider Identifier
1841437381
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PENNSYLVANIA DENTAL ASSOCIATES LTD
Practice address
604 S Washington SQ
Philadelphia, PA 19106-4118
Phone
(215) 627-0777
Fax
(215) 627-0778
NPI assigned
Jan 20, 2009
Last updated
Jan 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Authorized official

Name
Homayoun Safavi, DMD, M.SC. D.
Title
Owner
Phone
(215) 627-0777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

604 S Washington SQ
Philadelphia, PA 19106-4118

Mailing address

604 S Washington SQ
Philadelphia, PA 19106-4118
Phone (215) 627-0777

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1841437381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S WASHINGTON SQ",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064118",
            "telephone_number": "215-627-0777",
            "fax_number": "215-627-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WASHINGTON SQ",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191064118",
            "telephone_number": "215-627-0777",
            "fax_number": "215-627-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DENTAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "SAFAVI",
        "authorized_official_first_name": "HOMAYOUN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-627-0777",
        "authorized_official_credential": "DMD, M.SC. D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "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 Jan 20, 2009; 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.