WALLINGFORD SMILEMAKERS LLC NPI 1265838379

NPI Information

NPI: 1265838379
Provider Name: WALLINGFORD SMILEMAKERS LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 39D1060542

Address:
1 CHESTER RD
WALLINGFORD, PA
ZIP 19086
Phone: (610) 874-5700
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WALLINGFORD SMILEMAKERS LLC is a dental clinic center in Wallingford, PA. WALLINGFORD SMILEMAKERS LLC NPI is 1265838379. The provider is registered as an organization entity type.

The provider's business location address is:

1 CHESTER RD
WALLINGFORD, PA
ZIP 19086-601
Phone: (610) 874-5700
Fax: (610) 872-5348

The provider's authorized official is Ronald Michael Hayes .
The authorized official title is Owner/dentist and has the following contact phone number (610) 874-5700.

The CLIA number assigned to this NPI record is 39D1060542 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/17/2014 and was last updated on 11/18/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	DS028517L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7370300001	OTHER	PENNSYLVANIA	MEDICARE PCAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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