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BRIDGEWATER FAMILY DENTAL NPI 1710240858


NPI Information

NPI: 1710240858
Provider Name: BRIDGEWATER FAMILY DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 31D0123815

Address:
676 ROUTE 202/206
BRIDGEWATER, NJ
ZIP 08807
Phone: (908) 722-6666
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BRIDGEWATER FAMILY DENTAL is a general practice dentist in Bridgewater, 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. BRIDGEWATER FAMILY DENTAL NPI is 1710240858. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

676 ROUTE 202/206
BRIDGEWATER, NJ
ZIP 08807-761
Phone: (908) 722-6666
Fax: (908) 722-6667

The provider's authorized official is Marwan Bassil Bassil .
The authorized official title is Owner and has the following contact phone number (908) 722-6666.

The CLIA number assigned to this NPI record is 31D0123815 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2012 and was last updated on 7/30/2015.


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
11223E0200XDentistEndodontics22 DI 02249700NEW JERSEYNo
21223G0001XDentistGeneral Practice22 DI 02312200NEW JERSEYNo
31223G0001XDentistGeneral Practice22DI020751NEW 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
17367850001MEDICARE NSCNEW 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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