PEDIATRIC DENTAL ASSOC., LTD (NPI# 1538231220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538231220 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTAL ASSOC., LTD |
| Practice Address |
6404 Roosevelt Blvd Philadelphia PA 19149-2943 |
| Practice Telephone | 2157433700 |
| Practice Fax Number | 2157433706 |
| Mailing Telephone | 2157433700 |
| Mailing Fax Number | 2157433706 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | MRS. JOANNE COLL (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 2157433700 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEDIATRIC DENTAL ASSOCIATES, LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DS018048L | PA | Dental Providers |
| Street Address |
6404 ROOSEVELT BLVD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19149-2943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104810530 | Michael Rosenbaum | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2005-08-31 |
| 1740760818 | Ki Yoon Chung | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2018-08-17 |
| 1124512157 | Sasha Manchanda | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2018-06-22 |
| 1619258969 | Holly Do Nguyen | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2011-08-31 |
| 1639482011 | Casey Lauren Slaninabrooks | Registered Nurse | 6404 Roosevelt Blvd, Suite 1b, Philadelphia, PA 19149-2943 | 2010-07-14 |
| 1770806887 | The Andante Center, Inc | Clinic/Center | 6404 Roosevelt Blvd, Suite 1d, Philadelphia, PA 19149-2943 | 2010-03-03 |
| 1164750352 | Jacob Richard Orozco | Dentist | 6404 Roosevelt Blvd, 2nd Floor, Philadelphia, PA 19149-2943 | 2009-11-26 |
| 1851550826 | Delligatti & Milewski Orthodontic Group, P.C. | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2008-06-05 |
| 1023276656 | Pediatric Dental Associates Ltd | Dentist | 6404 Roosevelt Blvd, Lower Level, Philadelphia, PA 19149-2943 | 2008-05-30 |
| 1679749550 | Cichetti & Delligatti Orthodontics, P.C. | Dentist | 6404 Roosevelt Blvd, Philadelphia, PA 19149-2943 | 2008-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508418948 | Double Care Inc | Clinic/Center | 2900-14 Cottman Ave, Philadelphia, PA 19149 | 2019-07-16 |
| 1710539457 | Xiao Rong Li | Adult Companion | 2900 - 14 Cottman Avenue, Philadelphia, PA 19149 | 2019-07-12 |
| 1154982775 | K Dental LLC | Clinic/Center | 6214 Bustleton Avenue, Philadelphia, PA 19149 | 2019-06-25 |
| 1851950430 | Halo Staffing Agency, LLC | Home Health | 6401 Akron St., Philadelphia, PA 19149 | 2019-06-07 |
| 1518450626 | Family First Home Healthcare LLC | In Home Supportive Care | 1405 Alcott St, Philadelphia, PA 19149 | 2018-06-13 |
| 1992106926 | Elena Semprevivo | Dentist | 2107 Cottman Avenue, Philadelphia, PA 19149 | 2014-09-09 |
| 1518366988 | Abundant Life Home Health Services | Home Health | 6632-46 Bustleton Ave, Philadelphia, PA 19149 | 2014-08-21 |
| 1598189771 | Citywide Community Counseling Services | Clinic/Center | 1346 Knorr St, Philadelphia, PA 19149 | 2014-02-10 |
| 1114341328 | Citywide Community Counseling Services | Clinic/Center | 5807 Bustleton Avenue, Philadelphia, PA 19149 | 2014-02-07 |
| 1790115509 | Norman Huynh | Physical Therapist | 6595 B East Roosevelt Boulevard, Philadelphia, PA 19149 | 2013-11-14 |
| Find all providers in zip 19149 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235544008 | Lauren Julie Harper | Dentist | 8566 Bustleton Ave, Philadelphia, PA 19152-1218 | 2014-06-30 |
| 1871933036 | Mara Teplitsky | Dentist | 1616 Walnut St Apt 401, Philadelphia, PA 19103-5323 | 2013-07-02 |
| 1457799165 | Ross Andrew Levine | Dentist | 100 E. Lehigh Ave, Pedatric Dental Associates, Philadelphia, PA 19125 | 2013-06-05 |
| 1356570352 | Rosana Rosentrater | Dentist | 240 South 40th St Suite F-17, University of Pennsylvania School of Dental Medicine, Philadelphia, PA 19104-6003 | 2009-07-11 |
| 1790935898 | Monika Srivastava | Dentist | 1352 South St # C5c4, Philadelphia, PA 19147-1858 | 2008-09-25 |
| 1255594842 | Dana Kristanne Chianese | Dentist | 2301 E Allegheny Ave Ste 201, Philadelphia, PA 19134-4427 | 2008-07-03 |
| 1548464761 | George Thomas Lynch Iv | Dentist | 1352 South St, C5, Philadelphia, PA 19147-1858 | 2007-06-12 |
| 1053513614 | Rajbir Sanghvi | Dentist | 1835 Arch St Apt 903, Philadelphia, PA 19103-2779 | 2007-06-04 |
| 1477631562 | Howard Marvin Rosenberg | Dentist | 4001 Spruce St, Pediatric Dentistry, Philadelphia, PA 19104-4118 | 2006-11-02 |
| 1669402517 | Douglas Richard Reich | Dentist | 7122 Rising Sun Ave, Philadelphia, PA 19111-3957 | 2006-07-04 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19149 |
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.