Organization Active NPI

Langhorne Dental Associates LLC

  • Dentist
  • Langhorne, PA
National Provider Identifier
1952631749
Registry record updated Sep 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LANGHORNE DENTAL ASSOCIATES LLC
Practice address
330 Middletown Boulevard
Langhorne, PA 19047
Phone
(215) 757-1574
Fax
(215) 757-4909
NPI assigned
Dec 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2022

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

Authorized official

Name
Mr. Gerardo Ivan Portes
Title
Controller
Phone
(215) 650-4955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

330 Middletown Boulevard
Langhorne, PA 19047

Mailing address

330 Middletown Boulevard
Langhorne, PA 19047
Phone (215) 757-1574

Other names 1

  • Simply Beautiful Smiles of Langhorne Doing business as

National Provider Directory

National Provider Directory

Locations

330 Middletown Blvd
Langhorne, PA 19047
Phone (215) 757-1574

680 Middletown Blvd
Langhorne, PA 19047

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1952631749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MIDDLETOWN BOULEVARD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047",
            "telephone_number": "215-757-1574",
            "fax_number": "215-757-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MIDDLETOWN BOULEVARD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "19047",
            "telephone_number": "215-757-1574",
            "fax_number": "215-757-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANGHORNE DENTAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "PORTES",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_middle_name": "IVAN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "215-650-4955",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Beautiful Smiles of Langhorne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.