NPIMap

Organization Active NPI

Pennsylvania Dental Partners, LLC

  • General Practice Dentistry
  • Leola, PA
National Provider Identifier
1891032629
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS026808L Issued in PA
Legal business name
PENNSYLVANIA DENTAL PARTNERS, LLC
Practice address
355 W Main St
Leola, PA 17540-2107
Phone
(717) 656-3051
Fax
(717) 656-6205
NPI assigned
Jan 14, 2013
Last updated
Jan 14, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
BLACKFORD DENTAL MANAGEMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Dr. Thomas P. Dudas Jr., DMDNPI 1528148780
Title
Owner
Phone
(717) 519-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS026808L PA Primary

Addresses

Primary practice location

355 W Main St
Leola, PA 17540-2107

Mailing address

120 N Pointe Blvd
Ste.300
Lancaster, PA 17601-4100
Phone (717) 519-0100

National Provider Directory

National Provider Directory

Locations

120 N Pointe Blvd
Ste 300
Lancaster, PA 17601

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1891032629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N POINTE BLVD",
            "address_2": "STE.300",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014100",
            "telephone_number": "717-519-0100",
            "fax_number": "717-569-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W MAIN ST",
            "city": "LEOLA",
            "state": "PA",
            "postal_code": "175402107",
            "telephone_number": "717-656-3051",
            "fax_number": "717-656-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNSYLVANIA DENTAL PARTNERS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLACKFORD DENTAL MANAGEMENT",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "DUDAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-519-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS026808L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leola, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.