NPIMap

Organization Active NPI

Broad Axe Family Dentistry

  • General Practice Dentistry
  • Blue Bell, PA
National Provider Identifier
1972983609
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS039091 Issued in PA
Legal business name
BROAD AXE FAMILY DENTISTRY
Practice address
6198 Butler Pike
Suite 140
Blue Bell, PA 19422-2600
Phone
(215) 643-9858
Fax
(215) 643-9882
NPI assigned
Jun 8, 2015
Organization subpart
Yes
Parent organization
HERSHMAN FAMILY DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Dr. Jessica M Hershman, DMD
Title
Dentist
Phone
(215) 643-9858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS039091 PA Primary

Addresses

Primary practice location

6198 Butler Pike
Suite 140
Blue Bell, PA 19422-2600

Mailing address

6198 Butler Pike
Suite 140
Blue Bell, PA 19422-2600
Phone (215) 643-9858

National Provider Directory

National Provider Directory
Tax ID family
Broad Axe Family Dentistry2 organizations share this tax ID, including this one
Part of
Broad Axe Family Dentistry

Other organizations with this tax ID 1

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

Locations

6198 Butler Pike
Ste 140
Blue Bell, PA 19422
Phone (215) 643-9858

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1433721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1972983609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6198 BUTLER PIKE",
            "address_2": "SUITE 140",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222600",
            "telephone_number": "215-643-9858",
            "fax_number": "215-643-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6198 BUTLER PIKE",
            "address_2": "SUITE 140",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222600",
            "telephone_number": "215-643-9858",
            "fax_number": "215-643-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD AXE FAMILY DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERSHMAN FAMILY DENTISTRY",
        "enumeration_date": "2015-06-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "HERSHMAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-643-9858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.