Anna Kornbrot DMD PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS021370L Issued in PA

Legal business name

ANNA KORNBROT DMD PC

Practice address

1601 Walnut Street
Ste 902
Phila, PA 19102

Phone

(215) 563-6263

Fax

(215) 563-9898

NPI assigned

Aug 4, 2006

Organization subpart

No

Name

Dr. Anna Kornbrot, DMDNPI 1588930515

Title

President

Phone

(215) 563-6263

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna Kornbrot, D.M.D.

  • Dentist
  • Philadelphia, PA
  • NPI 1588930515
  NPD (past) Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 20, 2012.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1992713796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WALNUT STREET",
            "address_2": "STE 902",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-563-6263",
            "fax_number": "215-563-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT STREET",
            "address_2": "STE 902",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-563-6263",
            "fax_number": "215-563-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA KORNBROT DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "KORNBROT",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-563-6263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS021370L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.