Provider Demographics
NPI:1780221200
Name:A & E DENTISTRY PLLC
Entity type:Organization
Organization Name:A & E DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:INNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VINNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-359-5411
Mailing Address - Street 1:1355 GABRIEL LN
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18974-6178
Mailing Address - Country:US
Mailing Address - Phone:215-359-5411
Mailing Address - Fax:
Practice Address - Street 1:410 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8003
Practice Address - Country:US
Practice Address - Phone:215-968-0142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty