CITY DENTAL LLC (NPI# 1972072908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972072908 |
| Entity Type | Organization |
| Organization Name | CITY DENTAL LLC |
| Practice Address |
1100 Washington Ave 2nd Floor Philadelphia PA 19147 |
| Practice Telephone | 2154624877 |
| Practice Fax Number | 2154624871 |
| Mailing Telephone | 2157040056 |
| Mailing Fax Number | 2154624871 |
| Enumeration Date | 2018-11-20 |
| Last Update Date | 2018-11-20 |
| Authorized Official Name | JAE CHAE (OWNER) |
| Authorized Official Telephone | 2154624877 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 102705580 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467721969 | City Dental LLC | Dentist | 439 Broadway, Everett, MA 02149-3612 | 2011-12-29 |
| Street Address |
1100 WASHINGTON AVE 2ND FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336181 | Jamica Cropper-pam | Counselor | 401 S 2nd St. Suite 301, Philadelphia, PA 19147 | 2018-11-27 |
| 1598234411 | Halina Dziewolska | Behavioral Analyst | 535 Queen Street, Philadelphia, PA 19147 | 2018-11-20 |
| 1487120218 | Christopher Michael Rosado | Behavioral Analyst | 1218-20 South 8th St, 1, Philadelphia, PA 19147 | 2018-10-19 |
| 1891271722 | Candice Millard | Dietitian, Registered | 419 S 8th St Apt 1b, Philadelphia, PA 19147 | 2018-07-13 |
| 1669998217 | Julianne Leonarda Wiebalk | Counselor | 814 South 4th Street, 1st Floor, Philadelphia, PA 19147 | 2017-08-16 |
| 1396269247 | Sara Parente | Social Worker | 1217 Fitzwater St., Unit A, Philadelphia, PA 19147 | 2017-08-02 |
| 1609398445 | Nikele Riek | Social Worker | 1348 Bainbridge Street, Philadelphia, PA 19147 | 2017-07-13 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1194196105 | Ann Courto | Dietitian, Registered | 1140 Cross Street, Philadelphia, PA 19147 | 2015-10-16 |
| 1205205226 | Michael Shelton | Counselor | 525 South 4th Street, Suite 471, Equilibria, Philadelphia, PA 19147 | 2015-09-21 |
| Find all providers in zip 19147 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642897 | Walnut Street Smiles PC | Clinic/Center | 1601 Walnut St Ste 1025, Philadelphia, PA 19102-2911 | 2020-05-29 |
| 1215574355 | Smile Team PC | Clinic/Center | 9301 Banes St, Philadelphia, PA 19115-4201 | 2019-12-09 |
| 1558913129 | Advanced Dentistry of Center City | Clinic/Center | 1601 Walnut St Ste 600, Philadelphia, PA 19102-2904 | 2019-07-12 |
| 1841852241 | Cil Institute Inc | Clinic/Center | 3508 Market St Ste 256, Philadelphia, PA 19104-3320 | 2019-07-05 |
| 1154982775 | K Dental LLC | Clinic/Center | 6214 Bustleton Avenue, Philadelphia, PA 19149 | 2019-06-25 |
| 1598221129 | Minard Duka Dmd PC | Clinic/Center | 9501 Hilspach St, Philadelphia, PA 19115-3918 | 2019-02-19 |
| 1851855993 | Advanced Dentistry of Philadelphia | Clinic/Center | 7501 Stenton Ave, Philadelphia, PA 19150-3710 | 2019-01-23 |
| 1811468929 | Old City Orthodontics LLC | Clinic/Center | 14 S 3rd Street, 1st Floor, Philadelphia, PA 19106 | 2018-12-16 |
| 1972074250 | Center One Dental Associates PC | Clinic/Center | 9880 Bustleton Ave Ste 213, Philadelphia, PA 19115-2143 | 2018-12-11 |
| 1093298325 | Friendly Smile Dental Inc | Clinic/Center | 7608 Castor Ave 1 St Floor, Philadelphia, PA 19152 | 2018-09-12 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19147 |
Please comment or provide details below to improve the information on CITY DENTAL LLC.
| 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.