Pediatric Dental Health, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS038316 Issued in PA

Legal business name

PEDIATRIC DENTAL HEALTH, LLC

Practice address

2842 Street Rd
Bensalem, PA 19020-2651

Phone

(215) 208-1768

NPI assigned

Oct 3, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Raj Patel, DMD

Title

Owner

Phone

(267) 392-5878

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sea of Smiles Doing business as

Tax ID family

Pediatric Dental Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pediatric Dental Health LLC

  • Pediatric Dentistry
  • Bensalem, PA
  • NPI 1790222974
  NPD tax ID

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1952850802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OXFORD VALLEY RD",
            "address_2": "SUITE 1801",
            "city": "YARDLEY",
            "state": "PA",
            "postal_code": "190677706",
            "telephone_number": "267-392-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2842 STREET RD",
            "city": "BENSALEM",
            "state": "PA",
            "postal_code": "190202651",
            "telephone_number": "215-208-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-392-5878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS038316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102806206",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sea of Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pathmark Stores Inc
• Jack M. Payson, MA
• Lorena Peake, NP
• Louis Samuel Pearlstein, D.O.
• Pediatric Dental Health LLC
• Penn Life Care Health LLC
• Pennsylvania CVS Pharmacy LLC
• Pennsylvania CVS Pharmacy LLC
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania CVS Pharmacy, L.L.C.

• All providers in Bensalem, PA
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.