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NORTHEASTERN DENTISTRY @ OVERBROOK
NPI 1699073239
Dentist - General Practice in Philadelphia, PA

Active since March 07, 2011
6554 LEBANON AVE, PHILADELPHIA, PA 19151(215) 878-0058(877) 707-5571 Get Directions Write a Review

NPPES record last updated: September 30, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Northeastern Dentistry @ Overbrook NPPES

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

NORTHEASTERN DENTISTRY @ OVERBROOK (NPI 1699073239) is a healthcare organization registered as a general practice in Philadelphia, Pennsylvania and active in the NPI registry since March 2011. The organization lists Kavitha Chadhalavada, Owner Dentist, as its authorized official.

NPPES Registry Identity

NPI1699073239
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameNORTHEASTERN DENTISTRY @ OVERBROOK
Location Address6554 LEBANON AVEPhiladelphia, PA 19151-3328
Mailing Address6554 Lebanon AvePhiladelphia, PA 19151-3328 · (215) 878-0058 · Fax (877) 707-5571
Phone(215) 878-0058
Fax(877) 707-5571
Organization SubpartNo
Authorized OfficialKavitha ChadhalavadaOwner Dentist · (856) 325-0560
Enumeration DateMarch 7, 2011
Last NPPES UpdateSeptember 30, 2016
✔ NPI 1699073239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
6554 LEBANON AVE, Philadelphia, PA 19151
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Other Identifiers 1

Medicaid1020256650007PA

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.

KAVITHA CHADHALAVADA
Dentist
6554 LEBANON AVE
PHILADELPHIA, PA 19151
Philadelphia County (215) 878-0058

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 Northeastern Dentistry @ Overbrook's NPI number?

The NPI number for Northeastern Dentistry @ Overbrook is 1699073239. It was assigned to this organization in the NPPES registry on March 7, 2011.

Where is Northeastern Dentistry @ Overbrook located?

Northeastern Dentistry @ Overbrook is located at 6554 Lebanon Ave, Philadelphia, PA 19151. The listed phone number is (215) 878-0058.

What is Northeastern Dentistry @ Overbrook'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 Northeastern Dentistry @ Overbrook was last updated on September 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.