1477683829 NPI number — KAMINSKY DENTAL ASSOCIATES P C

Table of content: DR. JEFFREY C. FOSTER D.M.D. (NPI 1386835700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477683829 NPI number — KAMINSKY DENTAL ASSOCIATES P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAMINSKY DENTAL ASSOCIATES 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:
1477683829
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 MARKET ST
Provider Second Line Business Mailing Address:
CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19102-2100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-972-9722
Provider Business Mailing Address Fax Number:
215-972-0716

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 MARKET ST
Provider Second Line Business Practice Location Address:
CENTRE SQUARE BUILDING, LOWER MEZZANINE, WEST TOWER
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19102-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-972-9722
Provider Business Practice Location Address Fax Number:
215-972-0716
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KAMINSKY
Authorized Official First Name:
RANDE
Authorized Official Middle Name:
STEVEN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
215-972-9722

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DS024820L , 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)





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