GALLERY MALL DENTAL PC (NPI# 1902051535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902051535 |
| Entity Type | Organization |
| Organization Name | GALLERY MALL DENTAL PC |
| Practice Address |
901 Market St Space 3220 Gallery Mall One Philadelphia PA 19107 |
| Mailing Address |
901 Market St Space 3220 Philadelphia PA 19107 |
| Practice Telephone | 2156274290 |
| Practice Fax Number | 2156274293 |
| Mailing Telephone | 2156274290 |
| Mailing Fax Number | 2156274293 |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2009-12-18 |
| Authorized Official Name | PROLAY KUMAR PAUL (PARTNER) |
| Authorized Official Telephone | 2156274290 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | Y |
| Parent Organization Name | GALLERY MALL DENTAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 122300000X | Dentist | DS037088 | PA | Dental Providers |
| Y | 122300000X | Dentist | DS037098 | PA | Dental Providers |
| Street Address |
901 MARKET ST SPACE 3220 GALLERY MALL ONE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558745356 | Melanie Marie Mccoy | Pharmacist | 901 Market St, Philadelphia, PA 19107-3111 | 2015-07-13 |
| 1154750966 | Thien Nu Do | Pharmacist | 901 Market St, Philadelphia, PA 19107-3111 | 2013-11-02 |
| 1235408204 | Sharon L Ford | Pharmacist | 901 Market St, Walgreens, Philadelphia, PA 19107-3111 | 2011-12-21 |
| 1871861849 | Alexander C Chan | Pharmacist | 901 Market St, Philadelphia, PA 19107-3111 | 2011-12-06 |
| 1528342987 | Phuong Thuy Banh | Pharmacist | 901 Market St, Philadelphia, PA 19107-3111 | 2011-10-04 |
| 1083739403 | Charles Fecca | Technician/Technologist | 901 Market St, Philadelphia, PA 19107-3111 | 2007-03-21 |
| 1053464768 | C & J Optical Inc | Durable Medical Equipment & Medical Supplies | 901 Market St, The Gallery, Philadelphia, PA 19107-3111 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| 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 |
|---|---|---|---|---|
| 1396351318 | Mostafa Alwakeel | Dentist | 5450 Wissahickon Ave Apt B232, Philadelphia, PA 19144-5404 | 2020-09-16 |
| 1811508922 | Eleine Laffita Aguilera | Dentist | 4040 Spruce St Apt 5, Philadelphia, PA 19104-4130 | 2020-08-12 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1578172128 | Selena Nguyen | Dentist | 4837 N Broad St, Philadelphia, PA 19141-2107 | 2020-07-29 |
| 1447869235 | Artistic Smile LLC | Dentist | 2801 Island Ave Ste 5, Philadelphia, PA 19153-2326 | 2020-07-28 |
| 1619585270 | Dentist Near Me Pllc | Dentist | 1603 South St, Philadelphia, PA 19146-1541 | 2020-07-20 |
| 1073121281 | Olga Stepanchenko | Dentist | 1919 Bowler St, Philadelphia, PA 19115-3211 | 2020-07-14 |
| 1578101630 | Maryam Khalili | Dentist | 3223 N Broad St Ofc 314, Philadelphia, PA 19140-5007 | 2019-12-19 |
| 1952947152 | Navy Yard Dental Associates, Pllc | Dentist | 1 Crescent Dr Ste 300, Philadelphia, PA 19112-1015 | 2019-11-22 |
| 1518502632 | Rujuta Shukla | Dentist | 4055 Ridge Ave Apt 8402, Philadelphia, PA 19129-1666 | 2019-11-12 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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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.