1407466139 NPI number — QUALITY DENTAL CARE OF NJ

Table of content: (NPI 1407466139)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407466139 NPI number — QUALITY DENTAL CARE OF NJ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY DENTAL CARE OF NJ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407466139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 S MAIN ST FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILLIPSBURG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08865-2859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-386-2443
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
123 N 13TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18102-3795
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-434-9660
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2020

Additional Information

Authorized Official

Authorized Official Last Name:
RANA
Authorized Official First Name:
JAY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF INSURANCE
Authorized Official Telephone Number:
83-386-2443

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: NA . This is a "NA" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com