360 DENTAL PC NPI 1063893535

NPI Information

NPI: 1063893535
Provider Name: 360 DENTAL, PC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
1350 E LYCOMING ST
PHILADELPHIA, PA
ZIP 19124
Phone: (267) 242-1709
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360 DENTAL, PC is a dental clinic center in Philadelphia, PA. 360 DENTAL, PC NPI is 1063893535. The provider is registered as an organization entity type.

The provider's business location address is:

1350 E LYCOMING ST
PHILADELPHIA, PA
ZIP 19124-354
Phone: (267) 242-1709

The provider's authorized official is Mikhail Sitkovetsky .
The authorized official title is Owner/doctor and has the following contact phone number (215) 962-2242.

The enumeration date for this NPI number is 6/10/2015 and was last updated on 6/10/2015.

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	DS038816	PENNSYLVANIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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