PEDIATRIC DENTAL ASSOC LTD (NPI# 1386708121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386708121 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOC LTD |
| Practice Address |
3509 N Broad St 6th Fl W Philadelphia PA 19140 |
| Mailing Address |
6404 Roosevelt Blvd Phila PA 19149 |
| Practice Telephone | 2157076411 |
| Practice Fax Number | 2157076417 |
| Mailing Telephone | 2157433700 |
| Mailing Fax Number | 2157433715 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | MICHAEL S ROSENBAUM (PARTNER) |
| Authorized Official Telephone | 2187433700 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC DENTAL ASSOCIATES LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS025205L | PA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0005297280003 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902961899 | Pediatric Dental Assoc Ltd | Dentist | 928 Jaymor Road, Suite 130a, Southampton, PA 18966 | 2006-12-22 |
| 1366507253 | Pediatric Dental Assoc Ltd | Dentist | 7 E Skippack Pike, Suite 100, Ambler, PA 19002-5308 | 2006-12-22 |
| 1457416356 | Pediatric Dental Assoc Ltd | Dentist | 100 E Lehigh Ave, Philadelphia, PA 19125 | 2006-12-22 |
| Street Address |
3509 N BROAD ST 6TH FL W |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669466793 | Riyaz Bashir | Internal Medicine | 3509 N Broad St, Philadelphia, PA 19140-5103 | 2005-09-05 |
| 1750841151 | Chloe Beiler | Physician Assistant | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2019-03-21 |
| 1770068041 | Chirantan Vinodbhai Mangukia | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-10-02 |
| 1891278933 | Temple Faculty Practice Plan, Inc | Speech-Language Pathologist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-14 |
| 1396228508 | Temple Faculty Practice Plan, Inc | Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1992288112 | Temple Faculty Practice Plan, Inc | Urology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-13 |
| 1023591781 | Temple Faculty Practice Plan, Inc | Otolaryngology | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1154804839 | Temple Faculty Practice Plan, Inc | Physical Therapist | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1902389646 | Temple Faculty Practice Plan, Inc | Neurological Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| 1245713908 | Temple Faculty Practice Plan, Inc | Orthopaedic Surgery | 3509 N Broad St, Philadelphia, PA 19140-4105 | 2018-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351318 | Mostafa Alwakeel | Dentist | 5450 Wissahickon Ave Apt B232, Philadelphia, PA 19144-5404 | 2020-09-16 |
| 1811508922 | Eleine Laffita Aguilera | Dentist | 4040 Spruce St Apt 5, Philadelphia, PA 19104-4130 | 2020-08-12 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1578172128 | Selena Nguyen | Dentist | 4837 N Broad St, Philadelphia, PA 19141-2107 | 2020-07-29 |
| 1447869235 | Artistic Smile LLC | Dentist | 2801 Island Ave Ste 5, Philadelphia, PA 19153-2326 | 2020-07-28 |
| 1619585270 | Dentist Near Me Pllc | Dentist | 1603 South St, Philadelphia, PA 19146-1541 | 2020-07-20 |
| 1073121281 | Olga Stepanchenko | Dentist | 1919 Bowler St, Philadelphia, PA 19115-3211 | 2020-07-14 |
| 1578101630 | Maryam Khalili | Dentist | 3223 N Broad St Ofc 314, Philadelphia, PA 19140-5007 | 2019-12-19 |
| 1952947152 | Navy Yard Dental Associates, Pllc | Dentist | 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 | 2019-11-22 |
| 1518502632 | Rujuta Shukla | Dentist | 4055 Ridge Ave Apt 8402, Philadelphia, PA 19129-1666 | 2019-11-12 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
Please comment or provide details below to improve the information on PEDIATRIC DENTAL ASSOC LTD.
| 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.