OVERBROOK FARMS DENTAL GROUP (NPI# 1568603744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568603744 |
| Entity Type | Organization |
| Organization Name | OVERBROOK FARMS DENTAL GROUP |
| Practice Address |
2121 N 63rd St Philadelphia PA 19151-2612 |
| Practice Telephone | 2158780058 |
| Practice Fax Number | 2158783834 |
| Mailing Telephone | 2158780058 |
| Mailing Fax Number | 2158783834 |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |
| Authorized Official Name | DR. MARY ROSTAMI (DENTIST) |
| Authorized Official Telephone | 2158780058 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS029137L | PA | Dental Providers |
| Street Address |
2121 N 63RD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19151-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205894789 | Rama L Yerneni | Dentist | 2121 N 63rd St, Philadelphia, PA 19151-2612 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346860145 | Antonio Mayhew | Home Health | 1244 N 64th St, Philadelphia, PA 19151 | 2020-04-21 |
| 1477078913 | Nikisha Davis | Marriage & Family Therapist | 7621 Brookhaven Road, Philadelphia, PA 19151 | 2017-08-05 |
| 1376066092 | Kialenah Stewart | Technician | 451 N Edgewood Street, Philadelphia, PA 19151 | 2017-07-25 |
| 1922413186 | My Community My Way | Day Training, Developmentally Disabled Services | 1715 North Felton Street, Philadelphia, PA 19151 | 2014-06-26 |
| 1245670033 | Harcum Healthcare Group, LLC | Home Health | 7401 Woodbine Avenue, Philadelphia, PA 19151 | 2013-06-26 |
| 1639515687 | Daniel A Rader | Dentist | 7300 City Ave Suite 210, Phila, PA 19151 | 2013-05-17 |
| 1053632547 | Nalini Venkateswaran | Pharmacist | 7564-7570 Haverford Avenue, Rite Aid Pharmacy, Philadelphia, PA 19151 | 2010-06-18 |
| 1740494533 | Suburban Rehabilitation Associates, LLC | Orthopaedic Surgery | 7225 Haverford Avenue, Philadelphia, PA 19151 | 2007-05-10 |
| 1902027741 | Ndeye Aissatou Lo | Pharmacist | 7564 Haverford Ave, Philadelphia, PA 19151 | 2007-05-01 |
| 1629295076 | Gaudenzia Inc | Clinic/Center | 701 North 63rd Street, Philadelphia, PA 19151 | 2007-04-19 |
| Find all providers in zip 19151 | ||||
| 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 | 19151 |
Please comment or provide details below to improve the information on OVERBROOK FARMS DENTAL GROUP.
| 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.