Innovative Implant & Oral Surgery Pc
Specialist
1300 Bridgetown Pike, Feasterville Trevose
Pennsylvania, 19053-4326
215-322-7810 215-322-7832
Innovative Implant & Oral Surgery Pc is a Specialist in Feasterville Trevose, Pennsylvania. It is located at 1300 Bridgetown Pike, Feasterville Trevose and it's customer support contact number is 215-322-7810. The authorized person of Innovative Implant & Oral Surgery Pc is Ms. Debra Robyn Lodise who is Office Manager of this DME and her contact number is 215-322-7810. Active license number of Innovative Implant & Oral Surgery Pc is DS017304L for Specialist in Pennsylvania. Innovative Implant & Oral Surgery Pc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Innovative Implant & Oral Surgery Pc is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
DME Supplier Details:
Innovative Implant & Oral Surgery Pc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Innovative Implant & Oral Surgery Pc |
| Type: | Specialist |
| Location: | 1300 Bridgetown Pike, Feasterville Trevose,
Pennsylvania, 19053-4326 |
| Phone: | 215-322-7810 |
| Fax: | 215-322-7832 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Debra Robyn Lodise |
| Position: | Office Manager |
| Contact Number: | 215-322-7810 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1679547707 |
| NPI Enumeration Date: | 15 Feb, 2006 |
| NPI Last Update On: | 10 Jan, 2023 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Innovative Implant & Oral Surgery Pc are as mentioned below.
| Specialization | License Number | State | Status | |
| Specialist | DS017304L | Pennsylvania | Primary | |
| Specialist | DS030984L | Pennsylvania | Secondary | |
| Customized Equipment | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 1615888 | Other | Pennsylvania | Salin Blue Shield |
| 0547613000 | Other | Pennsylvania | Keyst Group# |
| 4437 | Other | Pennsylvania | Aetna Nissman |
| 161558 | Other | Pennsylvania | Nissman Blue Shield |
| 747908 | Other | Pennsylvania | Blue Shield Group# |
Medicare Enrollment:
Innovative Implant & Oral Surgery Pc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 3375635642 | O20070816000828 | Innovative Implant & Oral Surgery Pc | PART B SUPPLIER - CLINIC/GROUP PRACTICE |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 1300 Bridgetown Pike,
Feasterville Trevose, Pennsylvania |
| Zip: | 19053-4326 |
| Phone Number: | 215-322-7810 |
| Fax Number: | 215-322-7832 |
Patients can reach Innovative Implant & Oral Surgery Pc at
1300 Bridgetown Pike, Feasterville Trevose, Pennsylvania or can
call on customer care at 215-322-7810.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.