DR. TIMOTHY MEDIANICK (NPI# 1750596045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750596045 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY MEDIANICK |
| Credential | D.M.D. |
| Practice Address |
430 Kenhorst Blvd Reading PA 19611-1830 |
| Mailing Address |
2 Bordeaux Dr Mohnton PA 19540-8905 |
| Practice Telephone | 6107750321 |
| Practice Fax Number | 6107778884 |
| Mailing Telephone | 7178231392 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2016-07-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS036510 | PA | Dental Providers |
| Street Address |
430 KENHORST BLVD |
| City | READING |
| State | PA |
| Zip Code | 19611-1830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700890415 | George B Clark | Dentist | 430 Kenhorst Blvd, Reading, PA 19611-1830 | 2006-07-28 |
| 1659509404 | Boulevard Dental Associates | Dentist | 430 Kenhorst Blvd, Reading, PA 19611-1830 | 2009-06-30 |
| 1356403109 | Christopher J Kosenske | Dentist | 430 Kenhorst Blvd, Reading, PA 19611-1830 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033645247 | Donna Connor | Nurse Practitioner | S. 6th Ave, Reading, PA 19611 | 2017-05-08 |
| 1215397286 | Brian Punnoose | Pharmacist | 301 S. 6th Avenue, West Reading, PA 19611 | 2016-03-03 |
| 1700273323 | Sheila Kalathil | Internal Medicine | 420 S 5th Avenue, West Reading, PA 19611 | 2015-04-21 |
| 1497174502 | Marianne Sharon | Counselor | 20-22 North 6th Ave., West Reading, PA 19611 | 2014-04-16 |
| 1699191718 | Meghan Ward | Nurse Practitioner | Bldg N Ground- 6th Avenue & Spruce Street, West Reading, PA 19611 | 2014-03-13 |
| 1821413378 | Elizabeth Rider-williams | Counselor | 6th Avenue & Spruce Street - K Bldg, West Reading, PA 19611 | 2014-02-20 |
| 1295050193 | John Oliver Mclain Jr. | Psychiatry & Neurology | S. 6th Ave and Spruce Street, West Reading, PA 19611 | 2010-04-02 |
| 1215252515 | Sara L Lee | Physician Assistant | S Sixth Ave and Spruce St, Thrmc Regional Cancer Center, West Reading, PA 19611 | 2010-03-30 |
| 1508012683 | Kathryn Mraz Marr | Physical Therapist | 629 Court St, West Reading, PA 19611 | 2008-08-08 |
| 1316116809 | Genesis House Reading | Clinic/Center | 697 Reading Avenue, West Reading, PA 19611 | 2008-02-28 |
| Find all providers in zip 19611 | ||||
| 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 |
|---|---|---|---|---|
| 1275073256 | Indiju3dental LLC | Dentist | 2121 Morgantown Rd., Reading, PA 19607 | 2017-02-24 |
| 1629455324 | Pooja Ahuja | Dentist | 3302 North 5th Street Hwy, Dental Dreams LLC, Reading, PA 19605 | 2015-05-01 |
| 1902242829 | Cyril V Leddy Jr. | Dentist | 312 Lancaster Ave, Reading, PA 19611-1607 | 2013-05-19 |
| 1578832796 | Amdent Ltd | Dentist | 620 Kenhorst Plz, Reading, PA 19607-3648 | 2011-12-16 |
| 1760751978 | Amdent Ltd | Dentist | 5500 Perkiomen Ave, Reading, PA 19606-3634 | 2011-12-16 |
| 1598992638 | Ritu Manchanda | Dentist | 3302 N 5th Street Hwy, Reading, PA 19605-2427 | 2009-06-16 |
| 1407083876 | Rajiv Kolandaivelu | Dentist | 3302 North Fifth Street Highway, Reading, PA 19605 | 2009-06-12 |
| 1508007212 | Lawrence Abouseif | Dentist | 2942 Saint Lawrence Ave, Reading, PA 19606-2233 | 2009-03-11 |
| 1528217783 | Alla Shikhanovich | Dentist | 315 Main St Ste 101315, Reading, MA 01867 | 2008-09-11 |
| 1467645101 | Jared M Merin | Dentist | 2230 N 5th Street Hwy, Reading, PA 19605-2802 | 2007-08-27 |
| Find all providers in READING | ||||
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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.