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1669349361 NPI number — NUSQUARE DENTAL

NPI Number: 1669349361
Health Care Provider/Practitioner: NUSQUARE DENTAL

Information about “1669349361” NPI (NUSQUARE DENTAL) exists in 1669349361 in HTML format HTML  |  1669349361 in plain Text format TXT  |  1669349361 in PDF (Portable Document Format) PDF  |  1669349361 in an XML format XML  formats.

NPI Number : 1669349361 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669349361",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "LUMINA DENTAL PLLC",
    "ParentOrgTIN": null,
    "OrgName": "NUSQUARE DENTAL",
    "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": "111 PARKVIEW WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEWTOWN SQUARE",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19073-2254",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-200-5165",
    "MailingAddressFaxNumber": "610-375-6923",
    "FirstLinePracticeLocationAddress": "218 S NEWTOWN STREET RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEWTOWN SQUARE",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19073-4000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-200-5165",
    "PracticeLocationAddressFaxNumber": "610-375-6923",
    "EnumerationDate": "10/20/2025",
    "LastUpdateDate": "10/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PITCHIKA",
    "AuthorizedOfficialFirstName": "NEELIMA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DENTIST",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "215-200-5165",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223G0001X",
        "TaxonomyName": "General Practice Dentistry",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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