Active NPI
Mary Contreras Salas
- Orthodontics and Dentofacial Orthopedics Dentistry
- Philadelphia, PA
National Provider Identifier
1891541520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 4440-24
- Practice address
- 240 S 40TH St
Philadelphia, PA 19104-6030 - Phone
- (215) 898-8898
- NPI assigned
- Apr 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 4440-24 | MS | Primary |
Addresses
Primary practice location
240 S 40TH St
Philadelphia, PA 19104-6030
Mailing address
957 Sherwood CT
Sterling, VA 20164-4831
Phone (630) 697-5958
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4440-24 | MS | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1891541520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "957 SHERWOOD CT",
"city": "STERLING",
"state": "VA",
"postal_code": "201644831",
"telephone_number": "630-697-5958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 S 40TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191046030",
"telephone_number": "215-898-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTRERAS SALAS",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-24",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MS",
"license": "4440-24",
"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 May 28, 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.