Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cd Pennsylvania Dental, PC

Organization Dentist · NPI 1174015671

Cd Pennsylvania Dental, PC is a Dentist in Philadelphia, Pennsylvania. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6012 Greene St
Philadelphia, PA 19144-2726
Phone: (215) 843-9400
Fax: (215) 843-3237
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X
General Practice Dentistry Taxonomy 1223G0001X

Record details

NPI number1174015671
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ty Justice — Director, Credentialing & Payer Rel · (512) 808-4984
Other names Drs. Melman, Ravett & Associates; Greene Street Dental
NPI enumeratedMay 31, 2018
Last updated in NPPESJune 30, 2025
Certification dateJune 30, 2025
Mailing address9825 Kenwood Rd Ste 200, Blue Ash, OH 45242-6252

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