Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Locust Street Periodontics Implant Dentistry LLC

Organization Periodontics · NPI 1063536290

Locust Street Periodontics Implant Dentistry LLC provides Periodontics in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.

Licensed in
PA
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1500 Locust St Ste 1408
Philadelphia, PA 19102-4314
Phone: (215) 732-4450
Fax: (215) 735-9886
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence DS018466L (PA)

Record details

NPI number1063536290
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Gian-Grasso — Owner · (215) 732-4450
NPI enumeratedMarch 16, 2007
Last updated in NPPESAugust 22, 2020
Mailing address1500 Locust St., Suite 1408, Philadelphia, PA 19102-4314

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