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PENN 1 DENTAL
NPI 1003204553
Dentist - General Practice in Philadelphia, PA

Active since January 07, 2015
1404 POINT BREEZE AVE, PHILADELPHIA, PA 19146(215) 290-8230 Get Directions Write a Review

NPPES record last updated: January 7, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Penn 1 Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENN 1 DENTAL (NPI 1003204553) is a healthcare organization registered as a general practice in Philadelphia, Pennsylvania and active in the NPI registry since January 2015. The organization lists Yefim Aranbayev, Dentist/president, as its authorized official.

NPPES Registry Identity

NPI1003204553
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePENN 1 DENTAL
Location Address1404 POINT BREEZE AVEPhiladelphia, PA 19146-4522
Mailing Address1404 Point Breeze AvePhiladelphia, PA 19146-4522 · (215) 290-8230
Phone(215) 290-8230
Organization SubpartNo
Authorized OfficialYefim AranbayevDentist/president · (215) 290-8230
Enumeration DateJanuary 7, 2015
✔ NPI 1003204553 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in PA · DS038565
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1404 POINT BREEZE AVE, Philadelphia, PA 19146
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Other Identifiers 1

Medicaid10259118000002PA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PENN 1 FAMILY DENTAL
Clinic/Center (Dental)
1404 POINT BREEZE AVE
PHILADELPHIA, PA 19146
Philadelphia County (215) 344-2141

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Penn 1 Dental's NPI number?

The NPI number for Penn 1 Dental is 1003204553. It was assigned to this organization in the NPPES registry on January 7, 2015.

Where is Penn 1 Dental located?

Penn 1 Dental is located at 1404 Point Breeze Ave, Philadelphia, PA 19146. The listed phone number is (215) 290-8230.

What is Penn 1 Dental's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Penn 1 Dental was last updated on January 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.