=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841978129
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DR. JUAQUAN SAVAGE
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2023
-----------------------------------------------------
Last Update Date | 08/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | TEMPLE UNIVERSITY HOSPITAL 2301 E ALLEGHENY AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19134
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-282-8000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 910 N LAKE SHORE DR APT 1820
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60611-1524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-951-5223
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | 12014851B
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------