NPIMap

Organization Active NPI

Spark Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
National Provider Identifier
1841997871
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SPARK ORTHODONTICS
Practice address
2301 E Allegheny Ave Ste 300M
Philadelphia, PA 19134-4427
Phone
(833) 543-7678
NPI assigned
Feb 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Phi Le
Title
Credentialing Manager
Phone
(267) 575-2321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2301 E Allegheny Ave Ste 300M
Philadelphia, PA 19134-4427

Mailing address

300 Willowbrook LN Ste 330
West Chester, PA 19382-5594

National Provider Directory

National Provider Directory
Tax ID family
Spark Orthodontics PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2301 E Allegheny Ave
Ste 300M
Philadelphia, PA 19134
Phone (267) 529-0990

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1841997871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILLOWBROOK LN STE 330",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193825594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E ALLEGHENY AVE STE 300M",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344427",
            "telephone_number": "833-543-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARK ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "PHI",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "267-575-2321"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "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 Feb 9, 2023; 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.