Enri Profka, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS044623 Issued in PA

Practice address

701 E Cathedral Rd Ste 43
Philadelphia, PA 19128-2128

Phone

(267) 748-2090

NPI assigned

May 24, 2024

Last updated

May 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sutton Dentistry PLLC

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1093424400
  NPD

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1962241216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3339 OAKMONT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191363510",
            "telephone_number": "267-361-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CATHEDRAL RD STE 43",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191282128",
            "telephone_number": "267-748-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFKA",
        "first_name": "ENRI",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, 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 May 24, 2024; 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.