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NPI Code Detail

MEDICARE: TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

MEDICARE: TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
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
11223P0700XProsthodontics
21223P0106XOral and Maxillofacial Pathology Dentistry
31223X2210XOrofacial Pain Dentistry
41223S0112XOral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number : 1912687187
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Provider Business Mailing Address
First Line : 3223 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-707-2900
Fax Number : 215-707-5885
Provider Business Practice Location Address
First Line : 3223 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-707-2900
Fax Number : 215-707-5885
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : CRISTINA VALENTIN
Credential :
Telephone Number : 215-707-0297
Provider Enumeration Date : 07/21/2023
Last Update Date : 05/12/2026

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1821086851 — TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Practice Location Address:
3223 N BROAD ST
PHILADELPHIA, PA
19140-5007
Practice Phone: 215-707-5437
Practice Fax: 215-707-5180

Directions to “TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION ” Practice Location

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