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THE SMILE SPA OF NORTH JERSEYLLC NPI 1710151089


NPI Information

NPI: 1710151089
Provider Name: THE SMILE SPA OF NORTH JERSEY,LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
251 GODWIN AVE
MIDLAND PARK, NJ
ZIP 07432
Phone: (201) 445-2797
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THE SMILE SPA OF NORTH JERSEY,LLC is a general practice dentist in Midland Park, NJ. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. THE SMILE SPA OF NORTH JERSEY,LLC NPI is 1710151089. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

251 GODWIN AVE
MIDLAND PARK, NJ
ZIP 07432-882
Phone: (201) 445-2797
Fax: (201) 445-8340

The provider's authorized official is Debra Rosenblatt .
The authorized official title is Proprieter and has the following contact phone number (201) 445-2797.

The enumeration date for this NPI number is 4/17/2008 and was last updated on 5/10/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics2920508NEW JERSEYNo
21223G0001XDentistGeneral Practice14180NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11301802MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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