ADVANCED DENTISTRY OF CITY LINE LLC (NPI# 1780928598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780928598 |
| Entity Type | Organization |
| Organization Name | ADVANCED DENTISTRY OF CITY LINE LLC |
| Practice Address |
5058 City Line Ave Philadelphia PA 19131-1441 |
| Practice Telephone | 2159216510 |
| Practice Fax Number | 2159216985 |
| Mailing Telephone | 2159216510 |
| Mailing Fax Number | 2159216985 |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |
| Authorized Official Name | DR. MEHDI NIKPARVAR (OWNER) |
| Authorized Official Telephone | 2159216510 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
5058 CITY LINE AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19131-1441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639472608 | Ronald K. Creecy | Dentist | 5058 City Line Ave, Philadelphia, PA 19131-1441 | 2010-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629678925 | Jonathan Welch | Student in an Organized Health Care Education/Training Program | 4200 E City Ave, Rowland Hall, Suite 207, Physician Assistant Department, Philadelphia, PA 19131 | 2020-10-27 |
| 1659970689 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 1575 North 25nd Street, Philadelphia, PA 19131 | 2020-10-21 |
| 1821629254 | Stephen Osowski | Student in an Organized Health Care Education/Training Program | 4170 City Avenue, Philadelphia, PA 19131 | 2020-02-04 |
| 1134774888 | Arti D Mistry | Dentist | 1126 Horsham Road, Philadelphia, PW 19131 | 2019-08-08 |
| 1275187221 | Grace Bernadette Farrelly | Occupational Therapist | 2101 Simpson House, Philadelphia, PA 19131 | 2019-07-29 |
| 1235795204 | Isd Renal Inc | Clinic/Center | 4952 Parkside Ave, Philadelphia, PA 19131 | 2019-05-15 |
| 1922502582 | Kevin David Wojcik | Student in an Organized Health Care Education/Training Program | Philadelphia College of Osteopathic Medicine, 4190 City Ave, Philadelphia, PA 19131 | 2018-03-20 |
| 1235633900 | Nadja Hill | Home Health | 5203 Diamond Street, Philadelphia, PA 19131 | 2018-03-19 |
| 1932623857 | Mercy Management of Sepa | Social Worker | 1575 N 52nd St Ste 800, Philadelphia, PA 19131 | 2017-08-02 |
| 1578092235 | Sarah Marie Hoder | Specialist/Technologist | 4000 Presidential Avenue, Philadlephia, PA 19131 | 2017-06-07 |
| Find all providers in zip 19131 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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| 1215574355 | Smile Team PC | Clinic/Center | 9301 Banes St, Philadelphia, PA 19115-4201 | 2019-12-09 |
| 1558913129 | Advanced Dentistry of Center City | Clinic/Center | 1601 Walnut St Ste 600, Philadelphia, PA 19102-2904 | 2019-07-12 |
| 1841852241 | Cil Institute Inc | Clinic/Center | 3508 Market St Ste 256, Philadelphia, PA 19104-3320 | 2019-07-05 |
| 1154982775 | K Dental LLC | Clinic/Center | 6214 Bustleton Avenue, Philadelphia, PA 19149 | 2019-06-25 |
| 1598221129 | Minard Duka Dmd PC | Clinic/Center | 9501 Hilspach St, Philadelphia, PA 19115-3918 | 2019-02-19 |
| 1851855993 | Advanced Dentistry of Philadelphia | Clinic/Center | 7501 Stenton Ave, Philadelphia, PA 19150-3710 | 2019-01-23 |
| 1811468929 | Old City Orthodontics LLC | Clinic/Center | 14 S 3rd Street, 1st Floor, Philadelphia, PA 19106 | 2018-12-16 |
| 1972074250 | Center One Dental Associates PC | Clinic/Center | 9880 Bustleton Ave Ste 213, Philadelphia, PA 19115-2143 | 2018-12-11 |
| 1972072908 | City Dental LLC | Clinic/Center | 1100 Washington Ave 2nd Floor, Philadelphia, PA 19147 | 2018-11-20 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19131 |
Please comment or provide details below to improve the information on ADVANCED DENTISTRY OF CITY LINE LLC.
| 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.