1831280924 NPI number — READING ORTHODONTIC GROUP

Table of content: (NPI 1831280924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831280924 NPI number — READING ORTHODONTIC GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
READING ORTHODONTIC GROUP
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:
ROG ORTHODONTICS
Provider Other Organization Name Type Code:
3
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:
1831280924
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1268 PENN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WYOMISSING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-374-4097
Provider Business Mailing Address Fax Number:
610-372-6119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
840 PENN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WYOMISSING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19610-3016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-374-4097
Provider Business Practice Location Address Fax Number:
484-734-1303
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PARISI
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ORTHODONTIST/OWNER
Authorized Official Telephone Number:
610-374-4097

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  DS021065L , 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)