City Dental LLC
Clinic/Center (Dental)

Address: 1100 Washington Ave 2nd Floor, Philadelphia, PA 19147
Phone: 2154624877

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).

Provider Overview

Nation Provider Identifier (NPI) 1972072908
Entity Type Organization
Organization Name CITY DENTAL LLC
Practice Address 1100 Washington Ave 2nd Floor
PA 19147
Practice Telephone 2154624877
Practice Fax Number 2154624871
Mailing Address 1100 Washington Ave 2nd Floor
PA 19147
Mailing Telephone 2157040056
Mailing Fax Number 2154624871
Authorized Official Name Jae Chae (OWNER)
Authorized Official Telephone 2154624877
Authorized Official Credential DMD
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2018-11-20
Last Update Date 2018-11-20

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 261QD0000X Clinic/Center · Dental Ambulatory Health Care Facilities

Other Provider Identifier

State Identifier Issuer Type Code
PA 102705580 MEDICAID

Providers with the same name

NPI Name Taxonomy Address Enumeration
1467721969 City Dental LLC Dentist 439 Broadway, Everett, MA 02149-3612 2011-12-29

Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

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Office Location

Street Address 1100 WASHINGTON AVE 2ND FLOOR
State PA
Zip Code 19147

Providers in the same zip code

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 Behavior Analyst 535 Queen Street, Philadelphia, PA 19147 2018-11-20
1487120218 Christopher Michael Rosado Behavior 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


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Zip Code 19147

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Dataset Information

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.