DENTAL IMPLANT & PERIODONTAL SURGEONS OF MAINE LINE, P.C. (NPI# 1477003531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477003531 |
| Entity Type | Organization |
| Organization Name | DENTAL IMPLANT & PERIODONTAL SURGEONS OF MAINE LINE, P.C. |
| Other Organization Name | SAM B. KHOURY, D.D.S., M.S. |
| Practice Address |
107 Commons Ct Chadds Ford PA 19317 |
| Mailing Address |
107 Commons Ct Chadds Ford PA 19317-9708 |
| Practice Telephone | 6105000610 |
| Mailing Telephone | 6105000610 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2018-07-18 |
| Authorized Official Name | DR. SAMER B KHOURY (PERIODONTIST) |
| Authorized Official Telephone | 6105000610 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DS037420 | PA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Sam B. Khoury, D.D.S., M.S. | Doing Business As Name - Organization |
| Street Address |
107 COMMONS CT |
| City | CHADDS FORD |
| State | PA |
| Zip Code | 19317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585102 | Devrick Jamal Cliett Sr. | Technician/Technologist | 225 Wilmington Pike, Suite 200, Chadds Ford, PA 19317 | 2019-12-12 |
| 1891277620 | Donald C. Cameron | General Practice | 718 Kennett Pike, Chadds Ford, PA 19317 | 2018-08-29 |
| 1780105999 | Kathleen Breslin | Clinical Neuropsychologist | 5 Christy Dr Ste 207, Chadds Ford, PA 19317 | 2017-06-28 |
| 1750823951 | Yildiz Omar Shah | Dentist | 8 Ponds Edge Dr Ste 2, Chadds Ford, PA 19317 | 2016-11-06 |
| 1528434495 | Judith Js Ochs | Pediatrics | 1213 Fairville Road, Chadds Ford, PA 19317 | 2015-08-14 |
| 1700294626 | Gabrielle Van Heest | Behavioral Analyst | 920 Baltimore Pike, Chadds Ford, PA 19317 | 2014-07-23 |
| 1497199483 | Jill Pagliei LLC | Chiropractor | 220 Wilmington Pike, Suite 4, Chadds Ford, PA 19317 | 2013-04-22 |
| 1285832543 | Kevin Sperling | Internal Medicine | 601 Chadds Ford Drive, Suite 100, Chadds Ford, PA 19317 | 2007-07-10 |
| 1164554804 | Lee Anderson | Psychologist | 260 Kennett Pike, Chadds Ford, PA 19317 | 2007-03-09 |
| 1629120571 | Robert George Tsaganos | Dentist | 225 Wilmington-west Chester Pike, Suite 102, Chadds Ford, PA 19317 | 2007-01-18 |
| Find all providers in zip 19317 | ||||
| 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 |
|---|---|---|---|---|
| 1508471913 | Martin L. Supowitz, Dmd, Msd, LLC | Dentist | 5433 Walnut St Ste 200, Pittsburgh, PA 15232-3215 | 2020-09-11 |
| 1780239228 | Hatboro Dental & Specialty LLC | Dentist | 122 N York Rd Ste 2, Hatboro, PA 19040-2622 | 2019-08-01 |
| 1679125835 | Amanda Marie Clemente | Dentist | 3501 Terrace St # B89, Pittsburgh, PA 15213-2523 | 2019-07-09 |
| 1235792458 | Fany Briseyda Ocampo | Dentist | 2137 Welsh Rd Ste 2a, Philadelphia, PA 19115-4963 | 2019-04-15 |
| 1043771447 | Kara Deanne Dragone | Dentist | 8890 Royal Manor Dr Apt 302, Allison Park, PA 15101-2783 | 2019-03-27 |
| 1801356423 | Nicholas Anzur | Dentist | 4225 Trindle Rd, Camp Hill, PA 17011-5752 | 2019-03-20 |
| 1992261036 | Manal Sabir | Dentist | 2200 Benjamin Franklin Pkwy Apt S1603, Philadelphia, PA 19130-3618 | 2019-02-13 |
| 1699242024 | Michael S Ayes Dds and Associates Pennsylvania Vi, PC | Dentist | 70 Buckwalter Rd Ste 309, Royersford, PA 19468-1846 | 2018-10-24 |
| 1043736051 | Miriam Ting | Dentist | 250 W Lancaster Ave Ste 215, Paoli, PA 19301-1751 | 2017-08-21 |
| 1104378611 | Natalie Amoa | Dentist | 8021b Castor Ave, Philadelphia, PA 19152-2733 | 2016-10-31 |
| Find all providers with the same taxonomy | ||||
| City | CHADDS FORD |
| Zip Code | 19317 |
Please comment or provide details below to improve the information on DENTAL IMPLANT & PERIODONTAL SURGEONS OF MAINE LINE, P.C..
| 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.