Individual provider Active NPI

Enid Porrata Doria, D.M.D.

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1922097575
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS-023728L Issued in PA
Practice address
101-103 E. Lehigh Ave.
2ND Floor
Philadelphia, PA 19125-1011
Phone
(215) 427-0405
Fax
(215) 427-0138
NPI assigned
Oct 17, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-023728L PA Primary

Addresses

Primary practice location

101-103 E. Lehigh Ave.
2ND Floor
Philadelphia, PA 19125-1011

Mailing address

101-103 E. Lehigh Ave.
2ND Floor
Philadelphia, PA 19125-1011
Phone (215) 427-0405

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160701000641 PA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9133411648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS-023728LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1922097575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101-103 E. LEHIGH AVE.",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251011",
            "telephone_number": "215-427-0405",
            "fax_number": "215-427-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101-103 E. LEHIGH AVE.",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251011",
            "telephone_number": "215-427-0405",
            "fax_number": "215-427-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRATA DORIA",
        "first_name": "ENID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-17",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-023728L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.