PENNSYLVANIA DENTAL PARTNERS, LLC
NPI 1891032629
Dentist - General Practice in Leola, PA

Active since January 14, 2013
355 W MAIN ST, LEOLA, PA 17540(717) 656-3051(717) 656-6205 Get Directions Write a Review

NPPES record last updated: January 14, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pennsylvania Dental Partners, Llc NPPES

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

PENNSYLVANIA DENTAL PARTNERS, LLC (NPI 1891032629) is a healthcare organization registered as a general practice in Leola, Pennsylvania and active in the NPI registry since January 2013. The organization lists Thomas P. Dudas, Owner, as its authorized official.

NPPES Registry Identity

NPI1891032629
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NamePENNSYLVANIA DENTAL PARTNERS, LLC
Location Address355 W MAIN STLeola, PA 17540-2107
Mailing Address120 N Pointe Blvd, Ste.300Lancaster, PA 17601-4100 · (717) 519-0100 · Fax (717) 569-8063
Fax(717) 656-6205
Organization SubpartYesParent: Blackford Dental Management
Authorized OfficialThomas P. DudasOwner · (717) 519-0100
Enumeration DateJanuary 14, 2013
NPI 1891032629 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 · DS026808L
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.

355 W MAIN ST, Leola, PA 17540

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 Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
39D1074950
Facility Type
Independent
Certificate Effective Date
November 09, 2023
Certificate Expiration Date
November 08, 2025
Laboratory Director
DR. FABIEN K. BAKSH
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Pennsylvania Dental Partners, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Dentist (General Practice)
355 W MAIN ST
LEOLA, PA 17540
Dentist (Pediatric Dentistry)
355 W MAIN ST
LEOLA, PA 17540

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891032629, enumerated as an "organization" on January 14, 2013.

The provider is located at 355 W MAIN ST LEOLA, PA 17540 and the phone number is (717) 656-3051.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.