PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS (NPI# 1417031923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417031923 |
Entity Type | Organization |
Organization Name | PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS |
Practice Address |
9880 Bustleton Ave #211-212 Philadelphia PA 19115-2185 |
Practice Telephone | 2156778686 |
Practice Fax Number | 2156777212 |
Mailing Telephone | 2156778686 |
Mailing Fax Number | 2156777212 |
Enumeration Date | 2006-10-24 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. ROBERT A LEVINE (OWNER) |
Authorized Official Telephone | 2156778686 |
Authorized Official Credential | DDS,PC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
DS022257L | PA | Dental Providers |
Street Address |
9880 BUSTLETON AVE #211-212 |
City | PHILADELPHIA |
State | PA |
Zip Code | 19115-2185 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356700835 | Pennsylvania Center for Dental Implants and Periodontics, LLC | Dentist | 9880 Bustleton Ave, Suite 211-212, Philadelphia, PA 19115-2185 | 2016-02-12 |
1346680519 | Ksenia Smirnov | Nurse Practitioner | 9880 Bustleton Ave, Suite 208, Philadelphia, PA 19115-2185 | 2013-07-02 |
1568765857 | Stephen E Band | Dentist | 9880 Bustleton Ave, Philadelphia, PA 19115-2185 | 2010-12-08 |
1003129685 | Janna Prater | Internal Medicine | 9880 Bustleton Ave, Suite 220, Philadelphia, PA 19115-2185 | 2010-07-23 |
1891010229 | Albert Einstein Medical Center | Pharmacy | 9880 Bustleton Ave, Suite 332, Philadelphia, PA 19115-2185 | 2010-03-29 |
1760604755 | Tatyana Shekhterman | Physical Therapist | 9880 Bustleton Ave, Philadelphia, PA 19115-2185 | 2007-05-02 |
1467679738 | Jane Mayrin | Internal Medicine | 9880 Bustleton Ave, Ste 220, Philadelphia, PA 19115-2185 | 2007-04-19 |
1144306275 | Robert A Levine | Dentist | 9880 Bustleton Ave, Suite 211-212, Philadelphia, PA 19115-2185 | 2006-10-31 |
1023110152 | Lisa K. Jablon | Surgery | 9880 Bustleton Ave, Suite 205, Philadelphia, PA 19115-2185 | 2006-09-01 |
1962513564 | Richard H. Greenberg | Surgery | 9880 Bustleton Ave, Suite 205, Philadelphia, PA 19115-2185 | 2006-08-31 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205442696 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2044 Red Lion Road, Philadelphia, PA 19115 | 2020-09-21 |
1639717762 | Cassondra Ondeck | Physical Therapist | Paul's Run Retirement Community, 9896 Bustleton Ave, Philadelphia, PA 19115 | 2019-12-19 |
1740747641 | Comfort Ride Transit Inc | Non-emergency Medical Transport (VAN) | 248 Geiger Road, Suite 201 Unit D, Philadelphia, PA 19115 | 2019-02-27 |
1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
1659857027 | Kiesha Anita Abney | Occupational Therapy Assistant | Chapel Manor (genesis Rehabilitation) 1104 Welsh Road, Philadelphia, PA 19115 | 2018-07-18 |
1457844870 | Philadelphia Discount Pharmacy LLC | Pharmacist | 842 Red Lion Road Unit 13, Philadephia, PA 19115 | 2018-06-11 |
1770001828 | Ciarra Bell | Occupational Therapist | 828 Red Lion Rd, Philadelphia, PA 19115 | 2017-09-08 |
1245604008 | Saria Ibrahim | Counselor | 9651 Clark Street, Philadelphia, PA 19115 | 2015-11-17 |
1124413166 | Global Dental Plus LLC | Dentist | 9630 Bustleton Av 2nd Fl, Philadelphia, PA 19115 | 2015-04-06 |
1932510161 | Miriam John | Occupational Therapist | 9997 Sandy Road, Philadelphia, PA 19115 | 2014-05-09 |
Find all providers in zip 19115 |
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 | 19115 |
Please comment or provide details below to improve the information on PENNSYLVANIA CENTER FOR DENTAL IMPLANTS AND PERIODONTICS.
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.