Active NPI
Adam Wolf, DMD
- Pediatric Dentistry
- Drexel Hill, PA
National Provider Identifier
1841639770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS039505
- Practice address
- 5030 State Rd # 2
Drexel Hill, PA 19026-4605 - Phone
- (610) 622-1949
- NPI assigned
- Jun 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS039505 | PA | |
| Pediatric Dentistry | 1223P0221X | DS039505 | PA | Primary |
Addresses
Primary practice location
5030 State Rd # 2
Drexel Hill, PA 19026-4605
Mailing address
950 N 3Rd St Unit 209
Philadelphia, PA 19123-2263
Other practice location 1
2821 Island Ave
Suite 210
Philadelphia, PA 19153-2300
Phone (215) 492-9291
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS039505 | PA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids Smiles | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1841639770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "950 N 3RD ST UNIT 209",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191232263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5030 STATE RD # 2",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190264605",
"telephone_number": "610-622-1949"
}
],
"practiceLocations": [
{
"address_1": "2821 Island Ave",
"address_2": "Suite 210",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191532300",
"country_code": "US",
"telephone_number": "215-492-9291",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLF",
"first_name": "ADAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS039505",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS039505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.