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NPI Code Detail

MEDICARE: DR. AISHA JAVED DMD

MEDICARE: DR. AISHA JAVED DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDS041919PA

General Provider Information

NPI Number : 1275012320
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AISHA JAVED DMD
Provider Business Mailing Address
First Line : 1729 FOX CHASE RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-1813
Country : US
Telephone Number : 215-462-4047
Fax Number :
Provider Business Practice Location Address
First Line : 1701 E MOYAMENSING AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-1931
Country : US
Telephone Number : 215-462-4047
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2018
Last Update Date : 08/09/2018

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