IndividualActive
Derek Swanson
NPI 1174100663 · Student in an Organized Health Care Education/Training Program · Philadelphia, PA
Provider details
- NPI number
- 1174100663
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3400 Civic Center Boulevard
4 South Pavilion, Department of Oral and Maxillofacial
Philadelphia, PA 19104
Phone: (215) 900-3506
Street-level locationGet directions
Mailing address
3400 Civic Center Boulevard
Philadelphia, PA 19104
Registry dates
- Enumerated
- 2021-03-29
- Last updated
- 2022-03-10
- Certified
- 2022-03-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.