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

Pennsylvania Center for Dental Implants and Periodontics, LLC

Organization Periodontics · NPI 1356700835

Pennsylvania Center for Dental Implants and Periodontics, LLC provides Periodontics in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2016.

Licensed in
PA
In the registry since
2016
Specialties on file
2
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

9880 Bustleton Ave Ste 211-212
Philadelphia, PA 19115-2185 Not confirmed with CMS for 10 years — call before visiting
Phone: (215) 677-8686
Fax: (215) 677-7212
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence DS022257L (PA)
Periodontics Taxonomy 1223P0300X · Licence DS039673 (PA)

Record details

NPI number1356700835
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tami Vishio — Office Manager · (215) 677-8686
NPI enumeratedFebruary 12, 2016
Last updated in NPPESFebruary 12, 2016
Mailing address9880 Bustleton Ave, Suite 211-212, Philadelphia, PA 19115-2185

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