INNOVATIVE DENTAL SERVICES, P.C. (NPI# 1003214875) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003214875 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE DENTAL SERVICES, P.C. |
| Practice Address |
7234 Rising Sun Ave Philadelphia PA 19111-3948 |
| Practice Telephone | 2157454313 |
| Practice Fax Number | 2157454388 |
| Mailing Telephone | 2157454313 |
| Mailing Fax Number | 2157454388 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2014-12-10 |
| Authorized Official Name | DR. OLGA KANDOV (OWNER) |
| Authorized Official Telephone | 2157454313 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS037628 | PA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811345275 | Innovative Dental Services, P.C. | Dentist | 5737 N Broad St, Philadelphia, PA 19141-2307 | 2016-05-26 |
| Street Address |
7234 RISING SUN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19111-3948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255628608 | Smile Designers LLC | Dentist | 7234 Rising Sun Ave, Philadelphia, PA 19111-3948 | 2011-07-06 |
| 1336488725 | Smile Designers Dental Center, LLC | Clinic/Center | 7234 Rising Sun Ave, Philadelphia, PA 19111-3948 | 2013-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036026 | Grace Agency Incorporated | Home Health | 433 Longshore Ave, Philadelphia, PA 19111 | 2020-09-08 |
| 1124517750 | Dana Christine Campetti | Physician Assistant | 700 Cottman Ave Ste 201, Philadelphia, PA 19111 | 2018-05-09 |
| 1235654286 | Dorotea Mutabdzic | Surgery | Fox Chase Cancer Center, 333 Cottman Ave, Dept of Surgical Oncology, Philadelphia, PA 19111 | 2017-08-11 |
| 1952841041 | Personal Care Home C&g | Point of Service | 6176 Newtown Ave, Philadelphia, PA 19111 | 2017-03-08 |
| 1477006849 | Fox Chase Cancer Center | Clinic/Center | 333 Cottman Ave., Philadelphia, PA 19111 | 2016-08-02 |
| 1578927521 | Peter Whooley | Student in an Organized Health Care Education/Training Program | Temple University/fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111 | 2016-04-06 |
| 1043673783 | Matthew Holzerman | Physical Therapy Assistant | 1148 Tabor Plz, Philadelphia, PA 19111 | 2016-03-31 |
| 1831563329 | Aging With Care Inc | Home Health | 1614 Loney St, Philadelphia, PA 19111 | 2015-11-20 |
| 1043687551 | Kenneth Marsaglia II | Preventive Medicine | 8414 Bridle Road, Philadelphia, PA 19111 | 2015-09-01 |
| 1700220514 | Lorraine A Tauriello | Counselor | 716 Ripley St, Philadelphia, PA 19111 | 2013-04-23 |
| Find all providers in zip 19111 | ||||
| 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 | 19111 |
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| 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.