Advanced Dental of Jersey City LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

18218 Issued in NJ

Legal business name

ADVANCED DENTAL OF JERSEY CITY LLC

Practice address

223 Mallory Ave
Jersey City, NJ 07304-1256

Phone

(201) 232-3358

NPI assigned

May 10, 2011

Last updated

May 10, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Demetrius Tsambazis, DMDNPI 1366590051

Title

Owner

Phone

(973) 586-4444

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter Demetrius Tsambazis, D.M.D.

  • Periodontics
  • Jersey City, NJ
  • NPI 1366590051
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1003108051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 MALLORY AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041256",
            "telephone_number": "201-232-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 MALLORY AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073041256",
            "telephone_number": "201-232-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL OF JERSEY CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "TSAMBAZIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "DEMETRIUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-586-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "18218",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "18218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Garden State Cardiology LLC
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• Advanced Interventional Radiology Services LLP

• Periodontics in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.