1245772318 NPI number — TEMPLE UNIVERSITY SCHOOL OF DENTISTRY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245772318 NPI number — TEMPLE UNIVERSITY SCHOOL OF DENTISTRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEMPLE UNIVERSITY SCHOOL OF DENTISTRY
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:
1245772318
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 S 10TH ST APT J
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:
19147-1252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 S 10TH ST APT J
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:
19147-1252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-629-9755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ISMAIL
Authorized Official First Name:
AMID
Authorized Official Middle Name:
Authorized Official Title or Position:
DEAN, SCHOOL OF DENTISTRY
Authorized Official Telephone Number:
215-707-2799

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , 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)





Copyright © 2007-2025 www.npivalidator.com