Dental Specialist of Philadelphia PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DS029728L Issued in PA

Legal business name

DENTAL SPECIALIST OF PHILADELPHIA PC

Practice address

10501 Academy Rd Ste C
Philadelphia, PA 19114-1137

Phone

(215) 237-1544

NPI assigned

Feb 9, 2015

Last updated

Feb 9, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jatin Movalia

Title

Manager

Phone

(215) 237-1544

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Kanak H Trivedi, DDS

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1033525654
  NPD (past)

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1912398272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 ACADEMY RD STE C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141137",
            "telephone_number": "215-237-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 ACADEMY RD STE C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141137",
            "telephone_number": "215-237-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALIST OF PHILADELPHIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-09",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "MOVALIA",
        "authorized_official_first_name": "JATIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-237-1544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "DS029728L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentalux, LLC
• Dentam Inc
• Dentex Dental Group

• Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2015; 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.