RECONSTRUCTIVE DENTISTRY, LLC (NPI# 1588019095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588019095 |
| Entity Type | Organization |
| Organization Name | RECONSTRUCTIVE DENTISTRY, LLC |
| Practice Address |
327 N Washington Ave Ste 609 Scranton PA 18503-1539 |
| Practice Telephone | 5709616030 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |
| Authorized Official Name | DAVID HAZZOURI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5709616030 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
112193 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE, INC. #1121 | #112193 | 01 |
| Street Address |
327 N WASHINGTON AVE STE 609 |
| City | SCRANTON |
| State | PA |
| Zip Code | 18503-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578124624 | Vishwadhipa Venkata Voore | Student in an Organized Health Care Education/Training Program | 111 North Washington Avenue, The Wright Center for Grad, Suite 1, Scranton, PA 18503 | 2019-06-27 |
| 1841859717 | Sreekant Avula | Student in an Organized Health Care Education/Training Program | 111 North Washington Avenue, The Wright Center for Gra, Suite 1, Scranton, PA 18503 | 2019-06-13 |
| 1942866124 | Kashyap Devendrabhai Kela | Student in an Organized Health Care Education/Training Program | 111 North Washington Avenue, The Wright Center, Suite 1, Scranton, PA 18503 | 2019-05-14 |
| 1265097778 | Mary Ann Sheerer | Registered Nurse | Geisinger Women's Health Obgyn Clinic, 531 Mount Pleasant Drive, 2nd Floor, Scranton, PA 18503 | 2019-05-09 |
| 1164913950 | Nirajan Regmi | Student in an Organized Health Care Education/Training Program | 111 N Washington Avenue, Scranton, PA 18503 | 2018-05-29 |
| 1801387394 | Talha Zain Tariq | Internal Medicine | 111 N Washington Ave., Scranton, PA 18503 | 2018-05-21 |
| 1013407253 | Ashwin Thatti | Student in an Organized Health Care Education/Training Program | 111 N. Washington Avenue, Scranton, PA 18503 | 2018-05-14 |
| 1972093474 | Anjalika Gupta | Student in an Organized Health Care Education/Training Program | The Wright Center for Graduate Medical Education, 111 N Washington Ave, Scranton, PA 18503 | 2018-05-10 |
| 1073002085 | Mousa Thalji | Student in an Organized Health Care Education/Training Program | 111 N. Washington Ave., Scranton, PA 18503 | 2018-05-04 |
| 1861999849 | Tomara Wilding | Counselor | 201 Lackawanna Ave Ste 302, Scranton, PA 18503 | 2018-04-06 |
| Find all providers in zip 18503 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851469738 | Lackawanna Surgery Center LLC | Clinic/Center | 415 Adams Avenue, Scranton, PA 18510 | 2006-12-01 |
| 1306958103 | Nei Ambulatory Surgery Center Inc PC | Clinic/Center | 204 Mifflin Ave, Scranton, PA 18503 | 2006-08-31 |
| 1124395330 | Scranton Hospital Company LLC | Clinic/Center | 746 Jefferson Ave, Scranton, PA 18510-1624 | 2011-11-17 |
| 1881983039 | Scranton Hospital Company LLC | Clinic/Center | 746 Jefferson Ave, Scranton, PA 18510-1624 | 2011-03-28 |
| 1831230788 | Lackawanna Physicians Ambulatory Surgery Center, LLC | Clinic/Center | 423 Scranton Carbondale Hwy, Scranton, PA 18508-1115 | 2007-02-12 |
| 1467592576 | Mercy Hospital Scranton | Clinic/Center | 746 Jefferson Ave, Scranton, PA 18510-1624 | 2007-02-07 |
| 1548235963 | The Scranton Pa Endoscopy Asc Lp | Clinic/Center | 517 Ash St, Suite 1, Scranton, PA 18509-2903 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871108068 | Tilden Ambulatory Surgery Center, LLC | Clinic/Center | 61 Industrial Dr, Hamburg, PA 19526-8768 | 2020-09-14 |
| 1447862834 | Us Cardio Washington LLC | Clinic/Center | 1000 Park Place Dr Ste 201, Washington, PA 15301-2064 | 2020-08-18 |
| 1518575778 | Eye Surgery of The Main Line, LLC | Clinic/Center | 333 E City Avenue, Two Bala Plaza, Bala Cynwyd, PA 19004-1501 | 2020-07-14 |
| 1053934919 | Doylestown Surgery Center, LLC | Clinic/Center | 593 West State Street, Doylestown, PA 18901 | 2020-05-26 |
| 1811534555 | Midlantic Urology Surgery Center, LLC | Clinic/Center | Valley Forge Office Center, Suite 100, 676-656 East Swedesford Road, Wayne, PA 19087 | 2019-12-02 |
| 1750927190 | Hermitage Endoscopy Center Inc | Clinic/Center | 949 N Hermitage Road, Hermitage, PA 16148 | 2019-11-20 |
| 1508400920 | Nazareth Endoscopy Center, LLC | Clinic/Center | 2401 Northampton St Ste 220, Easton, PA 18045-2764 | 2019-10-29 |
| 1235788878 | Integrated Surgical Institute, LLC | Clinic/Center | West Ridge Business Campus, 1001 James Drive, Leesport, PA 19533 | 2019-09-06 |
| 1841759040 | Beaver Valley Ambulatory Surgery Center, LLC | Clinic/Center | 79 Wagner Road, Suite 101, Monaca, PA 15061-2489 | 2019-03-18 |
| 1669931861 | Urology Health Surgery Center, LLC | Clinic/Center | 1974 Sproul Rd Ste 104, Broomall, PA 19008-3402 | 2019-03-18 |
| Find all providers with the same taxonomy | ||||
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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.