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PRECIDENT OF NEW JERSEY LLC NPI 1699346437


NPI Information

NPI: 1699346437
Provider Name: PRECIDENT OF NEW JERSEY, LLC
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1135 BROAD ST STE 100
CLIFTON, NJ
ZIP 07013
Phone: (973) 256-0103
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PRECIDENT OF NEW JERSEY, LLC is an oral and maxillofacial surgery dentist in Clifton, NJ. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. PRECIDENT OF NEW JERSEY, LLC NPI is 1699346437. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1135 BROAD ST STE 100
CLIFTON, NJ
ZIP 07013-346
Phone: (973) 256-0103
Fax: (973) 256-8066

The provider's authorized official is Scotty L Bolding .
The authorized official title is Owner and has the following contact phone number (479) 957-4611.

The enumeration date for this NPI number is 7/2/2021 and was last updated on 5/12/2023.


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
1204E00000XOral & Maxillofacial SurgeryNo
21223S0112XDentistOral and Maxillofacial SurgeryYes

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
122DI02335600OTHERNEW JERSEYNJ STATE LICENSE
222DI02335601OTHERNEW JERSEYNJ STATE LICENSE BRANCH OFFICE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.