Individual provider Active NPI

Aldo Profka, DMD

  • General Practice Dentistry
  • Jenkintown, PA
National Provider Identifier
1982221636
Registry record updated Sep 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS042764 Issued in PA
Practice address
261 Old York Rd Ste 330
Jenkintown, PA 19046-3710
Phone
(215) 885-2202
NPI assigned
Jun 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS042764 PA Primary

Addresses

Primary practice location

261 Old York Rd Ste 330
Jenkintown, PA 19046-3710

Mailing address

3339 Oakmont St
Philadelphia, PA 19136-3510
Phone (215) 410-6708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS042764PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Julie Robin Arouh DMD PC PastSince Oct 5, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1593388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632614400000",
    "number": "1982221636",
    "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": "215-410-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 OLD YORK RD STE 330",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463710",
            "telephone_number": "215-885-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROFKA",
        "first_name": "ALDO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-29",
        "last_updated": "2021-09-26",
        "certification_date": "2021-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS042764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2021; 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.