| Temple University Of The Commonwealth System Of Higher Education | |
|
3223 N Broad St Philadelphia PA 19140-5007 | |
| (215) 707-2900 | |
| (215) 707-5885 |
| Full Name | Temple University Of The Commonwealth System Of Higher Education |
|---|---|
| Speciality | Dentist |
| Location | 3223 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Angelina Fagan (FINANCIAL SUPERVISOR / MANAGER) |
| Authorized Official Contact | 2157072828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Temple University Of The Commonwealth System Of Higher Education 3223 N Broad St Philadelphia PA 19140-5007 Ph: (215) 707-2900 | Temple University Of The Commonwealth System Of Higher Education 3223 N Broad St Philadelphia PA 19140-5007 Ph: (215) 707-2900 |
| NPI Number | 1912687187 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 01/03/2024 |
| Medicare PECOS PAC ID | 2961314299 |
|---|---|
| Medicare Enrollment ID | O20241121003294 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912687187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Mehran Hossainizadeh |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1699732602 PECOS PAC ID: 9234100348 Enrollment ID: I20040803000847 |
| Provider Name | Aaron G Segal |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1083749675 PECOS PAC ID: 7416018148 Enrollment ID: I20151119001800 |
| Provider Name | Louis A Dipede |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508828443 PECOS PAC ID: 1557306602 Enrollment ID: I20191220000161 |
| Provider Name | Maryam Khalili |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1578101630 PECOS PAC ID: 4284161555 Enrollment ID: I20241227000283 |
| Provider Name | Shraddha Kamat |
|---|---|
| Provider Type | Practitioner - Oral And Maxillofacial Pathology |
| Provider Identifiers | NPI Number: 1265939052 PECOS PAC ID: 1355708454 Enrollment ID: I20250117000132 |
| Provider Name | Kushaldeep Fnu |
|---|---|
| Provider Type | Practitioner - Prosthodontics |
| Provider Identifiers | NPI Number: 1871292128 PECOS PAC ID: 6709303035 Enrollment ID: I20250509000502 |
| Provider Name | Shabnam Seyedzadeh Sabounchi |
|---|---|
| Provider Type | Practitioner - Orofacial Pain |
| Provider Identifiers | NPI Number: 1306622543 PECOS PAC ID: 4981121191 Enrollment ID: I20250509002225 |
| Provider Name | Fang-yu Su |
|---|---|
| Provider Type | Practitioner - Prosthodontics |
| Provider Identifiers | NPI Number: 1619562543 PECOS PAC ID: 8123545233 Enrollment ID: I20250512001526 |
Parul Barot Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2822 N 5th St, Philadelphia, PA 19133 Phone: 215-229-3040 Fax: 215-229-3041 | |
Joly Jacob, D.m.d., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 443 W Girard Ave, Philadelphia, PA 19123 Phone: 215-763-7985 Fax: 215-763-7987 | |
Penn 1 Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1404 Point Breeze Ave, Philadelphia, PA 19146 Phone: 215-290-8230 | |
Innovative Dental Services, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7234 Rising Sun Ave, Philadelphia, PA 19111 Phone: 215-745-4313 Fax: 215-745-4388 | |
Mayfair Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4612 Frankford Ave, Unit 10, Philadelphia, PA 19124 Phone: 215-333-8100 Fax: 215-333-8111 | |
Gilbert Dental Care, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Market St, Lower Lobby, Philadelphia, PA 19102 Phone: 215-972-0406 | |
Avenue Of The Arts Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 S Broad St, Philadelphia, PA 19146 Phone: 215-545-0660 Fax: 215-545-0665 |