DR. RICHARD C SQUILLARO (NPI# 1194161455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194161455 |
| Entity Type | Individual |
| Full Name | DR. RICHARD C SQUILLARO |
| Credential | DDS |
| Practice Address |
2546 S Broad St Philadelphia PA 19145-4638 |
| Practice Telephone | 2154636677 |
| Practice Fax Number | 2154631077 |
| Mailing Telephone | 2154636677 |
| Mailing Fax Number | 2154631077 |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DS017459L | PA | Dental Providers |
| Street Address |
2546 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-4638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881796985 | Ramin Bahram | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2006-09-01 |
| 1427319706 | Naveen Mohan | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2012-06-04 |
| 1396006979 | Laura Marija Barunas | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2012-05-31 |
| 1790044535 | Excel Endodontics of Pennsylvania, LLC | Clinic/Center | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2012-05-14 |
| 1104087535 | Melissa Vettraino | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2008-06-18 |
| 1932323235 | Richard C Squillaro D.d.s., PC | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2007-04-11 |
| 1134250517 | Oral Surgery Consultants of Pa PC | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2007-03-08 |
| 1780715029 | Brad E Richman | Dentist | 2546 S Broad St, Philadelphia, PA 19145-4638 | 2007-03-08 |
| 1518043397 | Jerome A Robbins | Dentist | 2546 S Broad St, Shunk St Entrance, Philadelphia, PA 19145-4638 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564350 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2300a Rear W Oregon Ave, Philadelphia, PA 19145 | 2020-10-05 |
| 1376069559 | Kyle James Hughes | Physical Therapist | 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 | 2017-08-18 |
| 1821519752 | John A Takacs Dmd | Clinic/Center | 1707w Passyunk Ave, Philadelphia, PA 19145 | 2017-06-30 |
| 1033573209 | Kenneth Donahue | Dentist | 1517 Packer Avenue, Philadelphia, PA 19145 | 2016-04-13 |
| 1437516895 | Kimberly Wyand | Physical Therapist | 2129 Oregon St, Philadelphia, PA 19145 | 2016-01-15 |
| 1760856538 | Liji Vipin | Nurse Practitioner | 1615 Oregon Ave, Philadelphia, PA 19145 | 2015-11-17 |
| 1528333846 | Gina Marie Doyle | Registered Nurse | 1930 S. Broad Street, Philadelphia, PA 19145 | 2012-03-20 |
| 1639446214 | Thao T Tran | Pharmacist | 2014-24 South Broad St, Philadelphia, PA 19145 | 2011-11-25 |
| 1649573171 | Phyllis Yang | Internal Medicine | 1700 S Broad St, Unit 201, Philadelphia, PA 19145 | 2010-12-05 |
| 1326364613 | South Philadelphia Open Mri, LLC | Clinic/Center | 1834 West Oregon Avenue, Philadelphia, PA 19145 | 2010-04-13 |
| Find all providers in zip 19145 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235792458 | Fany Briseyda Ocampo | Dentist | 2137 Welsh Rd Ste 2a, Philadelphia, PA 19115-4963 | 2019-04-15 |
| 1992261036 | Manal Sabir | Dentist | 2200 Benjamin Franklin Pkwy Apt S1603, Philadelphia, PA 19130-3618 | 2019-02-13 |
| 1104378611 | Natalie Amoa | Dentist | 8021b Castor Ave, Philadelphia, PA 19152-2733 | 2016-10-31 |
| 1558720094 | Fathi Elgaddari | Dentist | 1500 Locust St Apt 1715, Philadelphia, PA 19102-4337 | 2016-02-11 |
| 1790185528 | David Paul Semeniuk | Dentist | 3223 N Broad St Rm 302, Philadelphia, PA 19140-5007 | 2014-08-28 |
| 1740616895 | Periodontal Consultants PC | Dentist | 2546 S Broad St Rear, Philadelphia, PA 19145-4638 | 2013-09-20 |
| 1942548664 | Peter Robert Hunt | Dentist | 266 S 21st St, Philadelphia, PA 19103-4860 | 2013-01-31 |
| 1083999759 | Merriam Seyedain | Dentist | 3223 N Broad St Ste 2a07, Philadelphia, PA 19140-5007 | 2011-10-13 |
| 1710275284 | Juan Carlos Cabrera | Dentist | 220 S 16th St Ste 901, Philadelphia, PA 19102-3309 | 2011-07-18 |
| 1982867412 | Scott Nakamura | Dentist | 240 S 4th St # 300, Philadelphia, PA 19106-3722 | 2008-07-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19145 |
Please comment or provide details below to improve the information on DR. RICHARD C SQUILLARO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.