Mark Gerard Radomile, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS024123L Issued in PA

Practice address

4207 State Rd
Drexel Hill, PA 19026-3321

Phone

(610) 789-4066

Fax

(610) 789-8507

NPI assigned

Feb 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Studio of Drexel Hill

  • General Practice Dentistry
  • Drexel Hill, PA
  • NPI 1497618466
  NPD (past)
• John J. Radomile and Mark G. Radomile PTR

  dba Radomile Family Dental Care

  • General Practice Dentistry
  • Drexel Hill, PA
  • NPI 1871621946
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881720704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263321",
            "telephone_number": "610-789-4066",
            "fax_number": "610-789-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 STATE RD",
            "city": "DREXEL HILL",
            "state": "PA",
            "postal_code": "190263321",
            "telephone_number": "610-789-4066",
            "fax_number": "610-789-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADOMILE",
        "first_name": "MARK",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024123L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quality Angels Home Care Agency
• Geoffrey Rabie, DMD
• Bonnie L Rabinowitch, MD
• Radiation Oncology Associates of Delaware County
• John James Radomile Jr., DDS,FAGD
• Ali Rajabi-Estarabadi, MD
• Neeti Rastogi, MD
• Rediclinic of PA, LLC
• Aaron Relic, DO
• Revolutionary Perspectives, LLC

• General Practice Dentistry in Drexel Hill, PA
• Providers in Drexel Hill, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.