CCD Ardmore Family Dentistry, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CCD ARDMORE FAMILY DENTISTRY, LLC

Doing business as

The Office of Dr. Bellisario

Practice address

636 Wynnewood Rd
Ardmore, PA 19003-2626

Phone

(610) 642-7024

Fax

(610) 642-0658

NPI assigned

Dec 16, 2018

Last updated

Aug 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Beth Walsh

Title

Director of Operations

Phone

(610) 642-7024

Specialties & licenses 1

Addresses

Other names 1

• The Office of Dr. Bellisario Doing business as

Locations

Practitioners 2

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.

• Jeffrey Allen Bellisario, DDS

  • Dentist
  • Ardmore, PA
  • NPI 1881773836
  NPD (past)
• Daniel Patrick Tibbetts, D.M.D

  • Dentist
  • Philadelphia, PA
  • NPI 1083991053
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1952872228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 WYNNEWOOD RD",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032626",
            "telephone_number": "610-642-7024",
            "fax_number": "610-642-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 WYNNEWOOD RD",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190032626",
            "telephone_number": "610-642-7024",
            "fax_number": "610-642-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCD ARDMORE FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "WALSH",
        "authorized_official_first_name": "BETH",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "610-642-7024",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Office of Dr. Bellisario",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erik Scott Caplan, PT, DPT
• Care Lync South LLC
• Sue Riddle Carey, M.S.
• Terence Carroll, MSS
• Julia Cash, MFT
• Center for Psychological Services
• Chaudhry and Associates Inc.
• Zaheer Chaudhry, D.D.S.
• Dachuan Chen, PHARM. D.
• Maria C Chila, D.M.D.

• General Practice Dentistry in Ardmore, PA
• Providers in Ardmore, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.