ELITE DENTAL LLC (NPI# 1033614136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033614136 |
| Entity Type | Organization |
| Organization Name | ELITE DENTAL LLC |
| Practice Address |
5597 Tulip St Ste B4 Philadelphia PA 19124-1562 |
| Mailing Address |
350 N Clark St Ste 600 Chicago IL 60654-4782 |
| Practice Telephone | 2152888008 |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2020-03-12 |
| Authorized Official Name | PHIL KURAL (DIRECTOR DOCTOR CREDENTIALING) |
| Authorized Official Telephone | 3122744526 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467952903 | Elite Dental LLC | Dentist | 1210 Millersville Pike, Lancaster, PA 17603-6656 | 2018-02-20 |
| 1124543368 | Elite Dental LLC | Dentist | 400 W Allegheny Ave Ste B-1, Philadelphia, PA 19133-3639 | 2017-08-09 |
| 1013393628 | Elite Dental LLC | Dentist | 150 Macdade Blvd, G, Darby, PA 19023-1814 | 2015-08-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | ELITE DENTAL LLC | 602 West Ridge Drive, Tuttle, OK 73089 |
| Street Address |
5597 TULIP ST STE B4 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19124-1562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073174520 | Roxana L Maciejeski | Dentist | 5597 Tulip St Ste B4, Philadelphia, PA 19124-1562 | 2019-06-25 |
| 1811475437 | Jonathan Chen | Dentist | 5597 Tulip St Ste B4, Philadelphia, PA 19124-1562 | 2018-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
| 1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
| 1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
| 1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
| 1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
| 1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
| 1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
| 1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
| Find all providers in zip 19124 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385581 | Samir Zahedpasha | Dentist | 1933 Delancey Pl, Philadelphia, PA 19103-6611 | 2020-10-29 |
| 1164040424 | Aledy Miguelina Moreta | Dentist | 1813 Vineyard St, Philadelphia, PA 19130-2122 | 2020-07-13 |
| 1033737473 | David Agia | Dentist | 1318 Franklin Mills Cir # 807, Philadelphia, PA 19154-3130 | 2020-07-13 |
| 1710504113 | Hanna Lee | Dentist | 1616 S Rosewood St, Philadelphia, PA 19145-1519 | 2020-07-01 |
| 1982221636 | Aldo Profka | Dentist | 8001 Roosevelt Blvd Ste 304, Philadelphia, PA 19152-3039 | 2020-06-29 |
| 1558985317 | Oxford Dental LLC | Dentist | 5233 Oxford Ave, Philadelphia, PA 19124-1803 | 2020-06-07 |
| 1487277935 | Issam Ghaben | Dentist | 4210 Sansom St, Philadelphia, PA 19104-3589 | 2020-05-19 |
| 1508490509 | Mount Airy Family Dental LLC | Dentist | 1600 Ivy Hill Rd, Philadelphia, PA 19150-1008 | 2020-02-27 |
| 1801436506 | Special Outreach Services, PC | Dentist | 2301 E Allegheny Ave Ste 202, Philadelphia, PA 19134-4427 | 2020-01-10 |
| 1720624547 | Philadelphia Mills Dental Center | Dentist | 1318 Franklin Mills Cir #807, Philadelphia, PA 19154 | 2019-11-27 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19124 |
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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.