DR. KEISUKE WADA (NPI# 1376897793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376897793 |
| Entity Type | Individual |
| Full Name | DR. KEISUKE WADA |
| Credential | DMD |
| Practice Address |
3401 Market Street Suite 110 Philadelphia PA 19104 |
| Mailing Address |
150 E Wynnewood Rd #2a Wynnewood PA 19096 |
| Practice Telephone | 2155738400 |
| Mailing Telephone | 6106490570 |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DS039376 | PA | Dental Providers |
| Street Address |
3401 MARKET STREET SUITE 110 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306091525 | Margrit Maggio | Dentist | 3401 Market Street, Penn Dental At University City, Philadelphia, PA 19104 | 2008-12-02 |
| 1255578472 | Karen Elaine Miller | Dentist | 3401 Market Street, Suite 110 Penn Dental At University City, Philadelphia, PA 19104-6228 | 2009-01-09 |
| 1326283771 | Leily Razavi | Dentist | 3401 Market Street, Suite#110, Philadelphia, PA 19104 | 2008-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| 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 |
|---|---|---|---|---|
| 1235792458 | Fany Briseyda Ocampo | Dentist | 2137 Welsh Rd Ste 2a, Philadelphia, PA 19115-4963 | 2019-04-15 |
| 1992261036 | Manal Sabir | Dentist | 2200 Benjamin Franklin Pkwy Apt S1603, Philadelphia, PA 19130-3618 | 2019-02-13 |
| 1104378611 | Natalie Amoa | Dentist | 8021b Castor Ave, Philadelphia, PA 19152-2733 | 2016-10-31 |
| 1558720094 | Fathi Elgaddari | Dentist | 1500 Locust St Apt 1715, Philadelphia, PA 19102-4337 | 2016-02-11 |
| 1790185528 | David Paul Semeniuk | Dentist | 3223 N Broad St Rm 302, Philadelphia, PA 19140-5007 | 2014-08-28 |
| 1740616895 | Periodontal Consultants PC | Dentist | 2546 S Broad St Rear, Philadelphia, PA 19145-4638 | 2013-09-20 |
| 1942548664 | Peter Robert Hunt | Dentist | 266 S 21st St, Philadelphia, PA 19103-4860 | 2013-01-31 |
| 1083999759 | Merriam Seyedain | Dentist | 3223 N Broad St Ste 2a07, Philadelphia, PA 19140-5007 | 2011-10-13 |
| 1710275284 | Juan Carlos Cabrera | Dentist | 220 S 16th St Ste 901, Philadelphia, PA 19102-3309 | 2011-07-18 |
| 1982867412 | Scott Nakamura | Dentist | 240 S 4th St # 300, Philadelphia, PA 19106-3722 | 2008-07-03 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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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.