Provider Demographics
NPI:1891047023
Name:YEADON FAMILY DENTISTRY
Entity Type:Organization
Organization Name:YEADON FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DINESH
Authorized Official - Middle Name:S
Authorized Official - Last Name:TEWARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:484-461-7222
Mailing Address - Street 1:724 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3536
Mailing Address - Country:US
Mailing Address - Phone:484-461-7222
Mailing Address - Fax:484-461-7666
Practice Address - Street 1:724 CHURCH LN
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3536
Practice Address - Country:US
Practice Address - Phone:484-461-7222
Practice Address - Fax:484-461-7666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DREXEL HILL FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty