Healthcare Provider Details

I. General information

NPI: 1679487573
Provider Name (Legal Business Name): CONNER HEIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 CHICHESTER AVE
UPPER CHICHESTER PA
19014-2333
US

IV. Provider business mailing address

274 OAK AVE
MEDIA PA
19063-5717
US

V. Phone/Fax

Practice location:
  • Phone: 610-485-1991
  • Fax:
Mailing address:
  • Phone: 541-207-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS046091
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: