1396969036 NPI number — FRANKLYN SCOTT, D.D.S., P.C.

Table of content: MS. CASSANDRA L. MILLER CAS (NPI 1063683530)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396969036 NPI number — FRANKLYN SCOTT, D.D.S., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLYN SCOTT, D.D.S., P.C.
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:
1396969036
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 EAST WADSWORTH AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19150
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-247-6962
Provider Business Mailing Address Fax Number:
215-247-0509

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 EAST WADSWORTH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-247-6962
Provider Business Practice Location Address Fax Number:
215-247-0509
Provider Enumeration Date:
04/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
FRANKLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
215-247-6962

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2244095000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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