Individual provider · Type 1 NPI

Elise Dedominicis, DDS

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1184288581 Active

Practice location

5501 Old York Rd
Philadelphia, PA 19141-3018

Call (215) 456-7890 Map

Mailing address

2112 Webster St
Philadelphia, PA 19146-1235

Other practice locations

  • 1 Gustave L Levy Pl, New York, NY 10029-6504 · (212) 241-6741

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000XDS042760 (PA)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1184288581

Elise Dedominicis, DDS's National Provider Identifier is 1184288581, issued on May 1, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 24, 2025.