Individual provider Active NPI

Noor Tarazi

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • King of Prussia, PA
National Provider Identifier
1841809688
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS041803 Issued in PA
Practice address
357 S Gulph Rd
King of Prussia, PA 19406-3136
Phone
(610) 337-2325
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22DI02811000 NJ
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS041803 PA Primary

Addresses

Primary practice location

357 S Gulph Rd
King of Prussia, PA 19406-3136

Mailing address

539 Championship Dr
Harleysville, PA 19438-2178
Phone (267) 252-3099

Other practice location 1

658 W Cuthbert Blvd
Haddonfield Township, NJ 08108-2178
Phone (856) 869-8660

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

LicenseStateTypeSpecialty
22DI02811000NJMDOrthodontics and Dentofacial Orthopedic Dentist
DS041803PAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverwalk Family Dental LLC PastSince May 9, 2021 Accepting new patients
John D Kernan DMD PA PastSince May 29, 2013 Accepting new patients

Organizations & group practices 2

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1841809688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 CHAMPIONSHIP DR",
            "city": "HARLEYSVILLE",
            "state": "PA",
            "postal_code": "194382178",
            "telephone_number": "267-252-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 S GULPH RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063136",
            "telephone_number": "610-337-2325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "658 W Cuthbert Blvd",
            "address_purpose": "LOCATION",
            "city": "Haddonfield Township",
            "state": "NJ",
            "postal_code": "081082178",
            "country_code": "US",
            "telephone_number": "856-869-8660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARAZI",
        "first_name": "NOOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02811000",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DS041803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; 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.