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1407767304 NPI number — DWK DENTAL LLC

NPI Number: 1407767304
Health Care Provider/Practitioner: DWK DENTAL LLC

Information about “1407767304” NPI (DWK DENTAL LLC) exists in 1407767304 in HTML format HTML  |  1407767304 in plain Text format TXT  |  1407767304 in PDF (Portable Document Format) PDF  |  1407767304 in an XML format XML  formats.

NPI Number : 1407767304 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407767304",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "DWK DENTAL LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "145 NUTT RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIXVILLE",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19460-3905",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "610-933-3881",
    "MailingAddressFaxNumber": "610-933-9383",
    "FirstLinePracticeLocationAddress": "145 NUTT RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHOENIXVILLE",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19460-3905",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "610-933-3881",
    "PracticeLocationAddressFaxNumber": "610-933-9383",
    "EnumerationDate": "09/17/2026",
    "LastUpdateDate": "09/17/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HOFFMAN",
    "AuthorizedOfficialFirstName": "ASHLEY",
    "AuthorizedOfficialMiddleName": "NICOLE",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RDH, PHDHP, EFDA",
    "AuthorizedOfficialTelephoneNumber": "610-955-9858",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QD0000X",
        "TaxonomyName": "Dental Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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