NPIMap

Organization Active NPI

Myorthos Pennsylvania Orthodontics PC

Doing business as Farrow Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
National Provider Identifier
1912676099
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MYORTHOS PENNSYLVANIA ORTHODONTICS PC
Doing business as
Farrow Orthodontics
Practice address
1510 E Wadsworth Ave
Philadelphia, PA 19150-1616
Phone
(215) 247-9060
NPI assigned
Sep 10, 2021
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MYORTHOS PENNSYLVANIA ORTHODONTICS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Casey Lonabocker
Title
VP Operations & Strategy
Phone
(617) 535-3364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1510 E Wadsworth Ave
Philadelphia, PA 19150-1616

Mailing address

131 Dartmouth St FL 3
Boston, MA 02116-5297
Phone (617) 535-3305

Other practice location 1

1601 Walnut St Ste 1315
Philadelphia, PA 19102-2908
Phone (215) 569-9060

Other names 1

  • Farrow Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Myorthos Pennsylvania Orthodontics PC6 organizations share this tax ID, including this one
Part of
Myorthos Pennsylvania Orthodontics PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1510 E Wadsworth Ave
Philadelphia, PA 19150
Phone (205) 247-9060

1601 Walnut St
Ste 1315
Philadelphia, PA 19102
Phone (215) 569-9060

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1912676099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DARTMOUTH ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165297",
            "telephone_number": "617-535-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E WADSWORTH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191501616",
            "telephone_number": "215-247-9060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Walnut St Ste 1315",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191022908",
            "country_code": "US",
            "telephone_number": "215-569-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYORTHOS PENNSYLVANIA ORTHODONTICS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MYORTHOS PENNSYLVANIA ORTHODONTICS PC",
        "enumeration_date": "2021-09-10",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Farrow Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 20, 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.

Verify at the official NPI Registry.