1538235593 NPI number — JANE ANN GRIFFITH & ASSOC

Table of content: (NPI 1538235593)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538235593 NPI number — JANE ANN GRIFFITH & ASSOC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JANE ANN GRIFFITH & ASSOC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538235593
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
04/30/2008
NPI Reactivation Date:
08/30/2011

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 BUBERRY AVE SUITE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HATBORO
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-972-2244
Provider Business Mailing Address Fax Number:
215-675-9730

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 BUBERRY AVE SUITE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HATBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-972-2244
Provider Business Practice Location Address Fax Number:
215-675-9730
Provider Enumeration Date:
11/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GRIFFITH
Authorized Official First Name:
JANE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
DENTIST OWNER
Authorized Official Telephone Number:
215-672-2244

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DS020061L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GR108576 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".




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