NPIMap

Organization Active NPI

Angel Smiles Pediatric Dentistry,P.C

  • Pediatric Dentistry
  • Berwyn, PA
National Provider Identifier
1871746933
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DS035020 Issued in PA
Legal business name
ANGEL SMILES PEDIATRIC DENTISTRY,P.C
Practice address
803 Heatherstone Dr
Berwyn, PA 19312-2506
Phone
(484) 410-4557
NPI assigned
Nov 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Dr. Shurong Cao, DMD
Title
Business Owner
Phone
(484) 410-4557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DS035020 PA Primary

Addresses

Primary practice location

803 Heatherstone Dr
Berwyn, PA 19312-2506

Mailing address

803 Heatherstone Dr
Berwyn, PA 19312-2506
Phone (484) 410-4557

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1871746933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 HEATHERSTONE DR",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122506",
            "telephone_number": "484-410-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 HEATHERSTONE DR",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122506",
            "telephone_number": "484-410-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL SMILES PEDIATRIC DENTISTRY,P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-02",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "CAO",
        "authorized_official_first_name": "SHURONG",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "484-410-4557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS035020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.