NPIMap

Organization Active NPI

Pristine Dental

  • Dentist
  • Upper Darby, PA
National Provider Identifier
1942577507
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS038565 Issued in PA
Legal business name
PRISTINE DENTAL
Practice address
392 Avon Rd
Upper Darby, PA 19082-4702
Phone
(610) 352-0500
NPI assigned
Nov 28, 2011
Last updated
Nov 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Dr. Yefim Aranbayev, DDSNPI 1194015743
Title
Dentist
Phone
(610) 352-0500

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
Dentist 122300000X DS038565 PA Primary

Addresses

Primary practice location

392 Avon Rd
Upper Darby, PA 19082-4702

Mailing address

392 Avon Rd
Upper Darby, PA 19082-4702
Phone (610) 352-0500

National Provider Directory

National Provider Directory

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": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1942577507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "392 AVON RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824702",
            "telephone_number": "610-352-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 AVON RD",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190824702",
            "telephone_number": "610-352-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "ARANBAYEV",
        "authorized_official_first_name": "YEFIM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "610-352-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.