Provider Demographics
NPI:1952193369
Name:BLOOMFIELD DENTAL
Entity type:Organization
Organization Name:BLOOMFIELD DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:216-346-2428
Mailing Address - Street 1:300 ALEXANDER CT APT 901
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1164
Mailing Address - Country:US
Mailing Address - Phone:216-346-2428
Mailing Address - Fax:
Practice Address - Street 1:4130 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-3803
Practice Address - Country:US
Practice Address - Phone:610-284-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty