TEMPLE UNIVERSITY
NPI 1720526130
Dentist - Periodontics in Philadelphia, PA

Active since February 06, 2017CLIA 39D2214224 · Waiver
3223 N BROAD ST, DEPT OF PERIODONTOLOGY, PHILADELPHIA, PA 19140(215) 707-5774 Get Directions Write a Review

NPPES record last updated: February 6, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Temple University NPPES

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

TEMPLE UNIVERSITY (NPI 1720526130) is a healthcare organization registered as a periodontics in Philadelphia, Pennsylvania and active in the NPI registry since February 2017. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Keisuke Wada, Director Chair Of Periodontology, as its authorized official.

NPPES Registry Identity

NPI1720526130
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameTEMPLE UNIVERSITY
Location Address3223 N BROAD ST, DEPT OF PERIODONTOLOGYPhiladelphia, PA 19140-5007
Mailing Address3223 N Broad StPhiladelphia, PA 19140-5007 · (215) 707-5774
Organization SubpartNo
Authorized OfficialKeisuke WadaDirector Chair Of Periodontology · (215) 707-7667
Enumeration DateFebruary 6, 2017
NPI 1720526130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License Licensed in VA · 0401414955
Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

3223 N BROAD ST, Philadelphia, PA 19140

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 39D2214224

Temple Universitys School Of Podiatric Medicine · Philadelphia, PA
Active · expires Feb 19, 2027
CLIA Number39D2214224
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorDr. Maryann P. Hartzell
Laboratory Phone(215) 777-5713
Laboratory LocationTemple Universitys School Of Podiatric Medicine3223 N Broad Stree, Suite 150, Philadelphia, PA 19140
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

Dentist (General Practice)
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist (General Practice)
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist
3223 N BROAD ST
PHILADELPHIA, PA 19140
Anesthesiology
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist (General Practice)
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist (Oral and Maxillofacial Surgery)
3223 N BROAD ST
PHILADELPHIA, PA 19140
Dentist
3223 N BROAD ST
PHILADELPHIA, PA 19140

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 Temple University's NPI number?

The NPI number for Temple University is 1720526130. It was assigned to this organization in the NPPES registry on February 6, 2017.

Where is Temple University located?

Temple University is located at 3223 N Broad St Dept Of Periodontology, Philadelphia, PA 19140. The listed phone number is (215) 707-5774.

What is Temple University's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Does Temple University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 39D2214224) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Temple University was last updated on February 6, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.