Healthcare Provider Details

I. General information

NPI: 1659385201
Provider Name (Legal Business Name): ROBERT SCOTT NEWMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N BROAD STREET SUITE 201
LANSDALE PA
19446
US

IV. Provider business mailing address

2100 N BROAD STREET SUITE 201
LANSDALE PA
19446
US

V. Phone/Fax

Practice location:
  • Phone: 215-855-1173
  • Fax: 215-855-1936
Mailing address:
  • Phone: 215-855-1173
  • Fax: 215-855-1936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS027102L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier113237
Identifier TypeOTHER
Identifier State
Identifier IssuerCIGNA
# 2
Identifier56307
Identifier TypeOTHER
Identifier State
Identifier IssuerPA DENTAL ASSOCIATION
# 3
IdentifierDS027102L
Identifier TypeOTHER
Identifier State
Identifier IssuerSTATE LICENSE
# 4
Identifier1560
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA DMO
# 5
Identifier054393
Identifier TypeOTHER
Identifier State
Identifier IssuerBLUE SHIELD
# 6
Identifier89839
Identifier TypeOTHER
Identifier State
Identifier IssuerAETNA
# 7
Identifier054393
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERIHEALTH
# 8
Identifier117712
Identifier TypeOTHER
Identifier State
Identifier IssuerAMERICAN ASSOC. OF ENDODO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: