Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Locust Street Periodontics Implant Dentistry LLC

Organization Periodontics · NPI 1063536290

Locust Street Periodontics Implant Dentistry LLC is a 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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