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NPI Code Detail

MEDICARE: DR. IVAN R MILORADOVIC DMD

MEDICARE: DR. IVAN R MILORADOVIC DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodonticsDS041783PA

General Provider Information

NPI Number : 1073091120
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IVAN R MILORADOVIC DMD
Provider Business Mailing Address
First Line : 643 WASHINGTON LN
Second Line :
City : JENKINTOWN
State : PA
Zip : 19046-2333
Country : US
Telephone Number : 610-547-3087
Fax Number :
Provider Business Practice Location Address
First Line : 3223 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-707-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2018
Last Update Date : 05/11/2026

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Directions to “ DR. IVAN R MILORADOVIC DMD” Practice Location

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