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GARDEN STATE SMILES OF BRICK NPI 1992165088


NPI Information

NPI: 1992165088
Provider Name: GARDEN STATE SMILES OF BRICK
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 31D2102613

Address:
525 ROUTE 70
BRICK, NJ
ZIP 08723
Phone: (732) 477-5770
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GARDEN STATE SMILES OF BRICK is a general practice dentist in Brick, 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. GARDEN STATE SMILES OF BRICK NPI is 1992165088. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

525 ROUTE 70
BRICK, NJ
ZIP 08723
Phone: (732) 477-5770

The provider's authorized official is Vlad Detinich .
The authorized official title is President and has the following contact phone number (732) 322-9297.

The CLIA number assigned to this NPI record is 31D2102613 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2016 and was last updated on 3/2/2016.


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
11223G0001XDentistGeneral PracticeDI021211NEW JERSEYYes

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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